Individual provider Active NPI

Jolie M. Hoffmann, PSY.D

  • Clinical Psychologist
  • Normal, IL
National Provider Identifier
1144243882
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Practice address
403 W Virginia Ave
Normal, IL 61761-3666
Phone
(309) 268-2910
Fax
(309) 268-2913
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

403 W Virginia Ave
Normal, IL 61761-3666

Mailing address

PO Box 2451
Bloomington, IL 61702-2451
Phone (309) 268-2172

Other identifiers 1

IdentifierTypeStateIssuer
05732028OtherBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20101008000746 IL Practitioner - Clinical Psychologist 2567654569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hoffmann Burchett Psychological Services LLCGroup PAC ID 7810189610, 2 clinicians

Practice addresses (Care Compare)

205 N Williamsburg Dr
Suite F
Bloomington, IL 61704-7721
Phone (309) 830-8099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071005978ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hoffmann Burchett Psychological Services, LLC Clinical CurrentSince Jul 30, 2011 Accepting new patients

Locations

205 N Williamsburg Dr
Bloomington, IL 61704
Phone (309) 222-8315

205 N Williamsburg Dr
Ste F
Bloomington, IL 61704
Phone (309) 830-8099

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144243882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2451",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617022451",
            "telephone_number": "309-268-2172",
            "fax_number": "309-268-3649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W VIRGINIA AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613666",
            "telephone_number": "309-268-2910",
            "fax_number": "309-268-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMANN",
        "first_name": "JOLIE",
        "middle_name": "M.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "05732028",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

Verify at the official NPI Registry.