Individual provider Active NPI

Jennifer Ann Goldman, PSY.D.

  • Clinical Psychologist
  • Jacksonville, FL
National Provider Identifier
1285965962
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8029 Issued in FL
Practice address
6867 Southpoint Dr N
Suite 106
Jacksonville, FL 32216-8043
Phone
(904) 619-6071
NPI assigned
Jan 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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 8029 FL Primary

Addresses

Primary practice location

6867 Southpoint Dr N
Suite 106
Jacksonville, FL 32216-8043

Mailing address

6867 Southpoint Drive North
Suite 106
Jacksonville, FL 32216
Phone (904) 619-6071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230203002287 FL Practitioner - Clinical Psychologist 9931571767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.81 of 100Reported as group
Quality
80.53
Improvement activities
40
Cost
75.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8029FLMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony United Florida, LLC CurrentSince Feb 6, 2023 Accepting new patients

Locations

3235 SW 34th St
Ocala, FL 34474
Phone 3525059115 ext. 100

15544 W Colonial Dr
Winter Garden, FL 34787
Phone (352) 504-0340

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1285965962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6867 SOUTHPOINT DRIVE NORTH",
            "address_2": "SUITE 106",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-619-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6867 SOUTHPOINT DR N",
            "address_2": "SUITE 106",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168043",
            "telephone_number": "904-619-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "8029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.