Gail M. Anderson, PSYD ABPP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY11004 Issued in FL

Practice address

3901 University Blvd S
Jacksonville, FL 32216-4312

Phone

(904) 345-7310

Fax

(904) 345-7240

NPI assigned

Oct 1, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesis Rehabilitation Hospital, Inc. 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Genesis Rehabilitation Hospital, Inc.

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1912947748

  FL

  Medicare reassignment Care Compare group NPD
• Genesis Rehabilitation Hospital, Inc.

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1376114413
  NPD

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1316340680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 RIVERPLACE BLVD APT 1810",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322079098",
            "telephone_number": "971-235-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164312",
            "telephone_number": "904-345-7310",
            "fax_number": "904-345-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "GAIL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PSYD ABPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-01",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MI",
            "license": "6301017240",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY11004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derrionn Shaunti Anderson
• Elizabeth Lindsay Anderson, PA-C
• Eric Ivan Anderson, PHARM.D
• Esther Anderson
• Frances Anderson
• Haley Elizabeth Anderson, PA-C, ATC
• Holly Noelle Anderson, PA-C
• Jennifer Noble Anderson, LCSW
• Jennifer Wannet Anderson
• Joette Eileen Anderson, A.R.N.P.

• All providers in Jacksonville, FL
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.