Individual provider Active NPI

Jody R Hoffman, PHD

  • Clinical Psychologist
  • Ann Arbor, MI
National Provider Identifier
1063425692
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301012389 Issued in MI
Practice address
202 E Washington St Ste 410
Ann Arbor, MI 48104-2017
Phone
(734) 660-9776
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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 6301012389 MI Primary

Addresses

Primary practice location

202 E Washington St Ste 410
Ann Arbor, MI 48104-2017

Mailing address

202 E Washington St Ste 410
Ann Arbor, MI 48104-2017
Phone (734) 660-9776

Other practice location 1

210 S 5th Ave
Ann Arbor, MI 48104-2216
Phone (734) 764-3471

Other identifiers 1

IdentifierTypeStateIssuer
750910475OtherMIBCBS PIN

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301012389MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jody Hoffman PHD PLLC Clinical Current Accepting new patients
University of Michigan-University Center for the Child and Family PastSince Jul 28, 2024 Accepting new patients
University of Michigan Psychological Clinic PastSince Jul 28, 2024 Accepting new patients

Locations

202 E Washington St
Ste 410
Ann Arbor, MI 48104
Phone (734) 660-9776

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1063425692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E WASHINGTON ST STE 410",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042017",
            "telephone_number": "734-660-9776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E WASHINGTON ST STE 410",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042017",
            "telephone_number": "734-660-9776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 S 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481042216",
            "country_code": "US",
            "telephone_number": "734-764-3471",
            "fax_number": "734-764-8128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "JODY",
        "middle_name": "R",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2024-03-27",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301012389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "750910475",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.