Individual provider Active NPI

Jessica Marie Solis Sloan, PHD

  • Clinical Psychologist
  • Raleigh, NC
National Provider Identifier
1346883543
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5428 Issued in NC
Practice address
4201 Lake Boone TRL Ste 201
Raleigh, NC 27607-7511
Phone
(919) 442-1123
Fax
(919) 785-0038
NPI assigned
Oct 21, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 5428 NC Primary

Addresses

Primary practice location

4201 Lake Boone TRL Ste 201
Raleigh, NC 27607-7511

Mailing address

4201 Lake Boone TRL Ste 201
Raleigh, NC 27607-7511
Phone (919) 442-1123

Other practice location 1

100 Europa Dr Ste 260
Chapel Hill, NC 27517-2394
Phone (919) 442-1123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2023 through Oct 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5428NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
HRC Behavioral Health & Psychiatry, PA Single Specialty CurrentSince Jul 1, 1990 Accepting new patients

Locations

100 Europa Dr
Ste 260
Chapel Hill, NC 27517
Phone (919) 929-1227

4201 Lake Boone Trl
Ste 201
Raleigh, NC 27607
Phone (919) 442-1123

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16901/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jessica.sloan.1@16901.direct.athenahealth.com

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": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1346883543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL STE 201",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077511",
            "telephone_number": "919-442-1123",
            "fax_number": "919-785-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL STE 201",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077511",
            "telephone_number": "919-442-1123",
            "fax_number": "919-785-0038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Europa Dr Ste 260",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275172394",
            "country_code": "US",
            "telephone_number": "919-442-1123",
            "fax_number": "919-968-2575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLOAN",
        "first_name": "JESSICA",
        "middle_name": "MARIE SOLIS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "5428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.