Active NPI
Jillian Nunn Bossemeyer, MS, CAS, LPA
- School Psychologist
- Charlotte, NC
National Provider Identifier
1346680279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 4305
- Practice address
- 617 N Summit Ave
Charlotte, NC 28216-5558 - Phone
- (716) 912-5575
- NPI assigned
- Jun 25, 2013
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 4305 | NC | Primary |
Addresses
Primary practice location
617 N Summit Ave
Charlotte, NC 28216-5558
Mailing address
3330 Spencer St
Charlotte, NC 28205-1149
Phone (716) 912-5575
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4305 | NC | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428451200000",
"number": "1346680279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3330 SPENCER ST",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282051149",
"telephone_number": "716-912-5575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "617 N SUMMIT AVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282165558",
"telephone_number": "716-912-5575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSSEMEYER",
"first_name": "JILLIAN",
"middle_name": "NUNN",
"name_prefix": "Mrs.",
"credential": "MS, CAS, LPA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-25",
"last_updated": "2015-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NC",
"license": "4305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.