Active NPI
Jacki Lynn Nesbitt, PSY.D.
- Clinical Psychologist
- Ormond Beach, FL
National Provider Identifier
1326046335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY 7098
- Practice address
- 570 Memorial Cir
Suite 150
Ormond Beach, FL 32174-5002 - Phone
- (386) 672-9250
- Fax
- (386) 672-9251
- NPI assigned
- Jul 13, 2005
- Last updated
- May 11, 2011
- Sex
- Female
- 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 | PY 7098 | FL | Primary |
Addresses
Primary practice location
570 Memorial Cir
Suite 150
Ormond Beach, FL 32174-5002
Mailing address
570 Memorial Cir
Suite 150
Ormond Beach, FL 32174-5002
Phone (386) 672-9250
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 7098 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305072000000",
"number": "1326046335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "570 MEMORIAL CIR",
"address_2": "SUITE 150",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321745002",
"telephone_number": "386-672-9250",
"fax_number": "386-672-9251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "570 MEMORIAL CIR",
"address_2": "SUITE 150",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321745002",
"telephone_number": "386-672-9250",
"fax_number": "386-672-9251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NESBITT",
"first_name": "JACKI",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-13",
"last_updated": "2011-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY 7098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ormond Beach, FL
- Navigating Today LLC
- Casey Neal
- Nefesh Psychiatry LLC
- Nemours Children's Health, Ormond Beach, Primary Care
- Neo Matrix (Neo Matrix Medical)
- Chelsea Nettles
- Sydney Kalin Neuhardt, MSN, CPNP-PC, ARNP
- Neurologic Consultants LLC
- Neurology Associates of Ormond Beach
- Neurology Associates of Ormond Beach PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.