Jeremy Glenn Gay, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY004116 Issued in GA

Practice address

811 Erika LN
Grovetown, GA 30813-8303

Phone

(706) 836-3983

NPI assigned

Feb 17, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1366035693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 ERIKA LN",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308138303",
            "telephone_number": "706-836-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 ERIKA LN",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308138303",
            "telephone_number": "706-836-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAY",
        "first_name": "JEREMY",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "GA",
            "license": "PSY004116",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felicia Raquel Fulton
• Dewey Gene Galeas, CRNA
• Taylor Lynn Gallaway
• Kenya Marian Gaston, NP
• Jennifer Dawn Gaughan
• Rebecca Smith Gay, PHARMD
• Georgia CVS Pharmacy, L.L.C.
• Georgia Dental Professionals, PC
• Georgia Dept. of Corrections
• Jacqueline Corinne Gibson, CMA-CPT-GANOTARY

• Clinical Psychologist in Grovetown, GA
• Providers in Grovetown, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.