Individual provider Active NPI

Joanna Ross, PH.D.

  • Clinical Psychologist
  • Tiverton, RI
National Provider Identifier
1356367882
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2916 Issued in MA
Practice address
63 Mainsail Dr
Tiverton, RI 02878-4283
Phone
(781) 254-1092
Fax
(401) 685-0352
NPI assigned
Jul 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2916 MA Primary

Addresses

Primary practice location

63 Mainsail Dr
Tiverton, RI 02878-4283

Mailing address

63 Mainsail Dr
Tiverton, RI 02878-4283
Phone (781) 254-1092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100818000022 MA Practitioner - Clinical Psychologist 1254465800 Practice locations: Needham, MA
I20220902000780 RI Practitioner - Clinical Psychologist 1254465800 Practice locations: Tiverton, RI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

63 Mainsail Dr
Tiverton, RI 02878-4283
Phone (781) 254-1092

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1356367882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MAINSAIL DR",
            "city": "TIVERTON",
            "state": "RI",
            "postal_code": "028784283",
            "telephone_number": "781-254-1092",
            "fax_number": "401-685-0352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 MAINSAIL DR",
            "city": "TIVERTON",
            "state": "RI",
            "postal_code": "028784283",
            "telephone_number": "781-254-1092",
            "fax_number": "401-685-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JOANNA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "2916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tiverton, RI

Sources for this page

Verify at the official NPI Registry.