NPIMap

Organization Active NPI

Augusta Psychological Associates

  • Psychosomatic Medicine Physician
  • Fishersville, VA
National Provider Identifier
1053416495
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X
License
0101041689 Issued in VA
Legal business name
AUGUSTA PSYCHOLOGICAL ASSOCIATES
Practice address
73 Wilson Blvd Ste 101
Fishersville, VA 22939-2286
Phone
(540) 949-4202
Fax
(540) 949-7109
NPI assigned
Sep 13, 2006
Last updated
Aug 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Dr. Thomas M Jayne, MD
Title
President
Phone
(540) 949-4202

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU
Clinical Psychologist 103TC0700X NU
Clinical Social Worker 1041C0700X NU
Psychosomatic Medicine Physician 2084P0015X 0101041689 VA Primary

Addresses

Primary practice location

73 Wilson Blvd Ste 101
Fishersville, VA 22939-2286

Mailing address

73 Wilson Blvd Ste 101
Fishersville, VA 22939-2286
Phone (540) 949-4202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040928000465 VA Part B Supplier - Clinic/Group Practice 4880663764 Receives reassigned benefits from 5 practitioners
Practice locations: Fishersville, VA

National Provider Directory

National Provider Directory

Locations

73 Wilson Blvd
Ste 101
Fishersville, VA 22939
Phone (540) 886-5060

1228 N Augusta St
Staunton, VA 24401
Phone (540) 886-5060

436 S Linden Ave
Ste C
Waynesboro, VA 22980
Phone (540) 886-5060

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1053416495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 WILSON BLVD STE 101",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392286",
            "telephone_number": "540-949-4202",
            "fax_number": "540-949-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 WILSON BLVD STE 101",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392286",
            "telephone_number": "540-949-4202",
            "fax_number": "540-949-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUGUSTA PSYCHOLOGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "JAYNE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-949-4202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "VA",
            "license": "0101041689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishersville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.