Active NPI
Tracy Jarvis
- Intellectual & Developmental Disabilities Psychologist
- Chesapeake, VA
National Provider Identifier
1154714285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual & Developmental Disabilities Psychologist
- License
- 1307
- Practice address
- 708 Harbor Quay
Chesapeake, VA 23320-2023 - Phone
- (757) 318-0157
- NPI assigned
- Mar 13, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 1307 | VA | Primary |
Addresses
Primary practice location
708 Harbor Quay
Chesapeake, VA 23320-2023
Mailing address
708 Harbor Quay
Chesapeake, VA 23320-2023
Phone (757) 318-0157
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1307 | VA | MD | Intellectual & Developmental Disabilities Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426204800000",
"number": "1154714285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "708 HARBOR QUAY",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233202023",
"telephone_number": "757-318-0157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "708 HARBOR QUAY",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233202023",
"telephone_number": "757-318-0157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARVIS",
"first_name": "TRACY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-13",
"last_updated": "2015-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "VA",
"license": "1307",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesapeake, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.