Individual provider Active NPI

Jamie Desjardins, PH.D., CCC-A

  • Audiologist
  • Syracuse, NY
National Provider Identifier
1366790974
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
001930-1 Issued in NY
Practice address
805 S Crouse Ave
Syracuse, NY 13210-1714
Phone
(315) 443-4485
Fax
(315) 443-1113
NPI assigned
Aug 29, 2012
Last updated
Aug 29, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 001930-1 NY Primary

Addresses

Primary practice location

805 S Crouse Ave
Syracuse, NY 13210-1714

Mailing address

805 S Crouse Ave
Syracuse, NY 13210-1714
Phone (315) 443-4485

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
001930NYMDBehavioral Analyst
001930-1NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse University PastSince Sep 26, 2012 Accepting new patients
Syracuse University Audiologist Past Accepting new patients
Syracuse University Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1366790974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 S CROUSE AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101714",
            "telephone_number": "315-443-4485",
            "fax_number": "315-443-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 S CROUSE AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101714",
            "telephone_number": "315-443-4485",
            "fax_number": "315-443-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESJARDINS",
        "first_name": "JAMIE",
        "name_prefix": "Dr.",
        "credential": "PH.D., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "001930-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.