Individual provider Active NPI

Jill Plevell, PH.D.

  • Clinical Psychologist
  • Tucson, AZ
National Provider Identifier
1053735225
Registry record updated Feb 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1957 Issued in AZ
Practice address
2410 W Ruthrauff Rd Ste 110
Tucson, AZ 85705-1952
Phone
(520) 440-1744
NPI assigned
Feb 9, 2014
Last updated
Feb 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1957 AZ Primary

Addresses

Primary practice location

2410 W Ruthrauff Rd Ste 110
Tucson, AZ 85705-1952

Mailing address

7440 N Bogert PL
Tucson, AZ 85741-1655
Phone (520) 440-1744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1957AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
L'Etoile de Le Nord, Inc. Clinical Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1391904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391904000000",
    "number": "1053735225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7440 N BOGERT PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857411655",
            "telephone_number": "520-440-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 W RUTHRAUFF RD STE 110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857051952",
            "telephone_number": "520-440-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLEVELL",
        "first_name": "JILL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-09",
        "last_updated": "2014-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "1957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.