Individual provider Active NPI

Jenny Bannister, PHD

  • Clinical Psychologist
  • St Petersburg, FL
National Provider Identifier
1225556145
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9940 Issued in FL
Practice address
7901 4TH St N Ste 300
St Petersburg, FL 33702-4399
Phone
(813) 825-0918
Fax
(727) 618-0575
NPI assigned
Aug 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 9940 FL Primary

Addresses

Primary practice location

7901 4TH St N Ste 300
St Petersburg, FL 33702-4399

Mailing address

204 W Hilda St
Tampa, FL 33603-3660
Phone (813) 825-0918

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
Credentials
Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1225556145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W HILDA ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336033660",
            "telephone_number": "813-825-0918",
            "fax_number": "727-618-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N STE 300",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337024399",
            "telephone_number": "813-825-0918",
            "fax_number": "727-618-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNISTER",
        "first_name": "JENNY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "9940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; 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.