Ronald J. Jereb, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

22980 Issued in TX

Practice address

2010 Gilmer Road
Ste 107
Longview, TX 75604

Phone

(903) 295-3100

Fax

(903) 295-3511

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Brittain & Associates Inc

  dba Carousel Clinical Services

  • Clinical Psychologist
  • Ore City, TX
  • NPI 1285650457
  Medicare reassignment NPD

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250640000000",
    "number": "1356350912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 GILMER ROAD",
            "address_2": "STE 107",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "75604",
            "telephone_number": "903-295-3100",
            "fax_number": "903-295-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 GILMER ROAD",
            "address_2": "STE 107",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "75604",
            "telephone_number": "903-295-3100",
            "fax_number": "903-295-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEREB",
        "first_name": "RONALD",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2009-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "22980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147308401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Jayakar, M.D.
• JD Medical Supplies, Inc.
• Jeffrey M. Shea, MD, PA (Pulmonary - Critical Care Associates of East Texas)
• Alison Jensen
• Barbara Yantz Jereb, M.S., LPC
• Patrice L Jernegons, LCDC
• Peter Stevan Jerome, M.D.
• Jess Xpress, LLC
• Jessica Anderson PLLC (Dalmatian Place)
• Maanasa Jetty, M.D

• Clinical Psychologist in Longview, TX
• Providers in Longview, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; 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.