Individual provider Active NPI

Jessica Conner, PSY.D.

  • Psychologist
  • Ithaca, NY
National Provider Identifier
1376084822
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
023424 Issued in NY
Practice address
10 Graham Rd W
Ithaca, NY 14850-1055
Phone
(607) 257-2188
NPI assigned
Mar 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 023424 NY Primary

Addresses

Primary practice location

10 Graham Rd W
Ithaca, NY 14850-1055

Mailing address

10 Graham Rd W
Ithaca, NY 14850-1055
Phone (607) 257-2188

Other practice location 1

1290 Trumansburg Rd
Ithaca, NY 14850-1314
Phone (607) 319-5211

Other names 1

  • Jessica Reno Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
023424NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1376084822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GRAHAM RD W",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501055",
            "telephone_number": "607-257-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GRAHAM RD W",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501055",
            "telephone_number": "607-257-2188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1290 Trumansburg Rd",
            "address_purpose": "LOCATION",
            "city": "Ithaca",
            "state": "NY",
            "postal_code": "148501314",
            "country_code": "US",
            "telephone_number": "607-319-5211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNER",
        "first_name": "JESSICA",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "023424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "RENO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.