Active NPI
Jeffrey Baldridge, PH.D.
- Clinical Psychologist
- Dallas, TX
National Provider Identifier
1144834268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 25162
- Practice address
- 8140 Walnut Hill LN Ste 450
Dallas, TX 75231-4328 - Phone
- (214) 265-1965
- NPI assigned
- Sep 4, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 25162 | TX | Primary |
Addresses
Primary practice location
8140 Walnut Hill LN Ste 450
Dallas, TX 75231-4328
Mailing address
8140 Walnut Hill LN Ste 450
Dallas, TX 75231-4328
Phone (214) 265-1965
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25162 | Other | TX | TEXAS LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 20, 2022 through Feb 20, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25162 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599177600000",
"number": "1144834268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8140 WALNUT HILL LN STE 450",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314328",
"telephone_number": "214-265-1965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8140 WALNUT HILL LN STE 450",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314328",
"telephone_number": "214-265-1965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDRIDGE",
"first_name": "JEFFREY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-04",
"last_updated": "2020-09-04",
"certification_date": "2020-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "25162",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS LICENSE",
"identifier": "25162",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.