Jessica Nicole Shore, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS016961 Issued in PA

Practice address

3535 Market St FL 3
Philadelphia, PA 19104-3317

Phone

(215) 746-6700

NPI assigned

Aug 18, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• The Nava Center, Inc.

  • Clinic/Center
  • Philadelphia, PA
  • NPI 1144820754
  NPD Authorized official
• Psycare Solutions Inc

  • Clinical Psychologist
  • Elkins Park, PA
  • NPI 1316003270
  NPD (past)

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1225284516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S BROAD ST",
            "address_2": "17TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19110",
            "telephone_number": "267-603-3673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 MARKET ST FL 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043317",
            "telephone_number": "215-746-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2022-05-12",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Novak Shoop, PHD
• Stefanie S Shopa, PA-C
• Glenn Shopper, MD
• Blake Shore
• Eric Eugene Shore, D.O.
• Mira B Shore, PSYD.
• Nicole Shore
• Paul Michael Shore, MD
• Tara Shores, PA-S
• Djuan Deshonge Short, LCSW

• Clinical Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.