Ann Margaret Pollock, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2005028345 Issued in MO

Practice address

1303 Edgewood Dr
Jefferson City, MO 65109-1943

Phone

(573) 634-5400

Fax

(573) 635-9657

NPI assigned

Oct 18, 2006

Last updated

Sep 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Curators of the University of Missouri

  dba University Physicians Specialty Care Associates

  • Durable Medical Equipment & Medical Supplies
  • Columbia, MO
  • NPI 1356963201
  NPD
• JCMG Mental Health Clinic LLC

  dba Professional Therapy Center

  • Psychologist
  • Jefferson City, MO
  • NPI 1801951306

  Clinical

  NPD
• JCMG Mental Health, L.L.C.

  dba Jane Domke, PhD

  • Counseling Psychologist
  • Jefferson City, MO
  • NPI 1922163781
  NPD
• The Curators of the University of Missouri

  • Multi-Specialty Clinic/Center
  • Columbia, MO
  • NPI 1235126921
  NPD
• Tri-County Adult Day Care

  • Adult Day Care Clinic/Center
  • Marshfield, MO
  • NPI 1487945689
  NPD (past)
• Tri-County Psychological Services, Inc.

  • Counseling Psychologist
  • Marshfield, MO
  • NPI 1548306855
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1124109079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 EDGEWOOD DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651091943",
            "telephone_number": "573-634-5400",
            "fax_number": "573-635-9657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 EDGEWOOD DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651091943",
            "telephone_number": "573-634-5400",
            "fax_number": "573-635-9657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOCK",
        "first_name": "ANN",
        "middle_name": "MARGARET",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2005028345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.1",
            "affiliationName": "Bluemark LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "40 Sunset Ridge Rd Ste 120",
            "city": "New Paltz",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125611039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Pitera, PLPC
• Stephanie Rose Pitts, FNP-BC
• Plume Health, PC
• Calyssa C Plymell, PLPC
• Matthew James Pohlmann
• Kelby Pollock
• Polson Family Chiropractic, LLC
• Pope Dental Services LLC
• Bryan Michael Pope, D.D.S.
• Nancy Marie Pope, LMT

• Clinical Psychologist in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.