Active NPI
Jenifer L Powell, PHD
- Psychologist
- Raleigh, NC
National Provider Identifier
1225014723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3101
- Practice address
- 3000 New Bern Ave
Wakemed
Raleigh, NC 27610-1231 - Phone
- (919) 350-7846
- NPI assigned
- Dec 16, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3101 | NC | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 3101 | NC | |
| Health Service Psychologist | 103TH0100X | 3101 | NC | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 3101 | NC |
Addresses
Primary practice location
3000 New Bern Ave
Wakemed
Raleigh, NC 27610-1231
Mailing address
3024 New Bern Ave
Raleigh, NC 27610-1247
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6000856 | Medicaid | NC | |
| 6000751 | Medicaid | NC | |
| 046PP | Other | NC | BCBS NC |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468195200000",
"number": "1225014723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3024 NEW BERN AVE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276101247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 NEW BERN AVE",
"address_2": "WAKEMED",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276101231",
"telephone_number": "919-350-7846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "JENIFER",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-16",
"last_updated": "2016-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "3101",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NC",
"license": "3101",
"primary": false
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "NC",
"license": "3101",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "NC",
"license": "3101",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6000856",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6000751",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NC",
"identifier": "046PP",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.