Individual provider Active NPI

Jyotsna Milbourne, PH. D.

  • Psychologist
  • Martinsburg, WV
National Provider Identifier
1326237314
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
99 Tavern Rd
Martinsburg, WV 25401-2890
Phone
(304) 263-7023
NPI assigned
Oct 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X WV Primary

Addresses

Primary practice location

99 Tavern Rd
Martinsburg, WV 25401-2890

Mailing address

PO Box 1146
Martinsburg, WV 25402-1146
Phone (304) 263-7023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20071031000113 WV Practitioner - Clinical Psychologist 5698862183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

69 Clendening Dr
Kearneysville, WV 25430-4716
Phone (304) 283-0022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Continuous Journey CurrentSince Jun 1, 2020 Accepting new patients
Shenandoah Valley Medical System, Inc. Past Accepting new patients
Shenandoah Valley Medical System, Inc. Past Accepting new patients

Locations

69 Clendening Dr
Kearneysville, WV 25430
Phone (304) 283-0022

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1326237314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1146",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254021146",
            "telephone_number": "304-263-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 TAVERN RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254012890",
            "telephone_number": "304-263-7023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILBOURNE",
        "first_name": "JYOTSNA",
        "credential": "PH. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.