Individual provider Active NPI

Jennifer Marie Oglesby, PH.D.

  • Clinical Neuropsychologist
  • Lawrenceville, NJ
National Provider Identifier
1154535672
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
35SI00381200 Issued in NJ
Practice address
3100 Princeton Pike BLDG 3
Lawrenceville, NJ 08648-2300
Phone
(609) 575-4561
Fax
(609) 771-3753
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35SI00381200 NJ
Clinical Psychologist 103TC0700X 35SI00381200 NJ
Clinical Neuropsychologist 103G00000X 35SI00381200 NJ Primary

Addresses

Primary practice location

3100 Princeton Pike BLDG 3
Lawrenceville, NJ 08648-2300

Mailing address

PO Box 5957
Trenton, NJ 08638-0957
Phone (609) 575-4561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050526000219 NJ Practitioner - Clinical Psychologist 4183666456 Practice locations: Lawrenceville, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

133 Franklin Corner Rd
Lawrence Township, NJ 08648-2531
Phone (609) 575-4561

3100 Princeton Pike
Lawrenceville, NJ 08648-2300
Phone (609) 575-4561

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35SI00381200NJMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Neurobehavioral Institute of New Jersey, P.a. Clinical Neuropsychologist Past Accepting new patients

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1154535672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5957",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086380957",
            "telephone_number": "609-575-4561",
            "fax_number": "609-771-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 PRINCETON PIKE BLDG 3",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482300",
            "telephone_number": "609-575-4561",
            "fax_number": "609-771-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGLESBY",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00381200",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00381200",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "35SI00381200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, NJ

Sources for this page

Verify at the official NPI Registry.