Timi Dee Friederichs Jordison, PHD; EDS

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

001080 Issued in IA

Practice address

1728 Central Ave
Ste. 14
Fort Dodge, IA 50501-4200

Phone

(515) 573-3628

Fax

(515) 573-3682

NPI assigned

Oct 16, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Timi Jordison Psychological Services, P.C.

  • Psychologist
  • Fort Dodge, IA
  • NPI 1619203379
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281312000000",
    "number": "1043390818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 CENTRAL AVE",
            "address_2": "STE. 14",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505014200",
            "telephone_number": "515-573-3628",
            "fax_number": "515-573-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 CENTRAL AVE",
            "address_2": "STE. 14",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505014200",
            "telephone_number": "515-573-3628",
            "fax_number": "515-573-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDISON",
        "first_name": "TIMI",
        "middle_name": "DEE FRIEDERICHS",
        "name_prefix": "Dr.",
        "credential": "PHD; EDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2010-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IA",
            "license": "322774",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "001080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC/BS",
            "identifier": "07466",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0159608",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Marie Jondle-Howard, IADC
• Christine Kay Jondle, MANT
• Megan Jondle
• Melissa Kay Jones
• Myra J Jones, MSW, LISW, IADC
• Joshua J. Mason DC PC
• Coral M Jud, AU.D.
• Judith C Christensen, LLC
• Joi Ann Junkman
• Paige M Junkman, LMSW

• Clinical Psychologist in Fort Dodge, IA
• Providers in Fort Dodge, IA by specialty
• Clinical Psychologist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.