Active NPI
John A Jerome, PH.D.
- Clinical Psychologist
- East Lansing, MI
National Provider Identifier
1235159211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301001259
- Practice address
- 250 E Saginaw St
East Lansing, MI 48823-2740 - Phone
- (517) 337-3080
- Fax
- (517) 337-3082
- NPI assigned
- Jul 20, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301001259 | MI | Primary |
Addresses
Primary practice location
250 E Saginaw St
East Lansing, MI 48823-2740
Mailing address
250 E Saginaw St
East Lansing, MI 48823-2740
Phone (517) 337-3080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 680C345670 | Other | MI | BLUE CROSS BLUE SHIELD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301001259 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prime Radiology Consultants P.C. | Past | Accepting new patients | |
| Edward W Sparrow Hospital Association | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Adult Health Nurse Practitioner
- Lansing, MI
- NPI 1265220438
-
- Diagnostic Radiology Physician
- Owosso, MI
- NPI 1811723679
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247184000000",
"number": "1235159211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 E SAGINAW ST",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488232740",
"telephone_number": "517-337-3080",
"fax_number": "517-337-3082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 E SAGINAW ST",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488232740",
"telephone_number": "517-337-3080",
"fax_number": "517-337-3082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEROME",
"first_name": "JOHN",
"middle_name": "A",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2009-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301001259",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "680C345670",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.