Individual provider Active NPI

Jesse Winn

  • Clinical Psychologist
  • Lynchburg, VA
National Provider Identifier
1366851818
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810005798 Issued in VA
Practice address
2215 Langhorne Rd
Lynchburg, VA 24501-1121
Phone
(434) 948-4831
NPI assigned
Aug 8, 2014
Last updated
Jan 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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 0810005798 VA Primary

Addresses

Primary practice location

2215 Langhorne Rd
Lynchburg, VA 24501-1121

Mailing address

2241 Langhorne Rd
Lynchburg, VA 24501-1114
Phone (434) 455-3402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20171212001497 VA Practitioner - Clinical Psychologist 0547528937 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Behavioral Health CurrentSince Nov 1, 2017 Accepting new patients
Horizon Behavioral Health Past Accepting new patients

Locations

2215 Langhorne Rd
Lynchburg, VA 24501
Phone (434) 948-4831

2235 Landover Pl
Lynchburg, VA 24501
Phone (434) 847-8000

2241 Langhorne Rd
Lynchburg, VA 24501
Phone (434) 455-3045

Organizations & group practices 2

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": "1407456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1366851818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 LANGHORNE RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011114",
            "telephone_number": "434-455-3402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 LANGHORNE RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011121",
            "telephone_number": "434-948-4831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINN",
        "first_name": "JESSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-08",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.