Individual provider Active NPI

Anna-Marie Roland, PSYD

  • Clinical Psychologist
  • Jacksonville, FL
National Provider Identifier
1104606227
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
11984 Issued in FL
Practice address
3901 University Blvd S
Jacksonville, FL 32216-4312
Phone
(904) 345-7210
Fax
(904) 345-7255
NPI assigned
Oct 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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 11984 FL Primary

Addresses

Primary practice location

3901 University Blvd S
Jacksonville, FL 32216-4312

Mailing address

3599 University Blvd S
Jacksonville, FL 32216-4252

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20231020003163 FL Practitioner - Clinical Psychologist 4082060413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Rehabilitation Hospital, Inc.Group PAC ID 4284664954, 8 clinicians

Practice addresses (Care Compare)

3901 University Blvd S
Jacksonville, FL 32216-4312
Phone (904) 858-7606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11984FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Rehabilitation Hospital, Inc. CurrentSince Oct 9, 2023 Accepting new patients
Genesis Rehabilitation Hospital, Inc. CurrentSince Oct 9, 2023 Accepting new patients

Locations

3599 University Blvd S
Jacksonville, FL 32216
Phone (904) 345-7600

3599 University Blvd S
Bldg 907
Jacksonville, FL 32216

3901 University Blvd S
Jacksonville, FL 32216
Phone (904) 345-7251

Organizations & group practices 2

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": "1696464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1104606227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3599 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164312",
            "telephone_number": "904-345-7210",
            "fax_number": "904-345-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLAND",
        "first_name": "ANNA-MARIE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-05",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "11984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.