Jaime Victoria Marra, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY8712 Issued in FL

Practice address

4320 Deerwood Lake Pkwy Ste 101-108
Jacksonville, FL 32216-1177

Phone

(904) 479-5120

NPI assigned

Dec 2, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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

• Jaime Marra, PHD, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jacksonville, FL
  • NPI 1245709559
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1376845933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 DEERWOOD LAKE PKWY STE 101-108",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161177",
            "telephone_number": "904-479-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 DEERWOOD LAKE PKWY STE 101-108",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161177",
            "telephone_number": "904-479-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRA",
        "first_name": "JAIME",
        "middle_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-02",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012365400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003173791A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth J Marquez, M.D.
• Stephanie Marquez
• Cassandra Marquis
• Danielle Marquis, DDS
• Denisa Marra, DNP, APRN, FNP-C
• James Edward Marra, APRN, FNP-BC
• Julia Marra, RBT
• Jelisse M Marrero, ARNP
• Married to Navy Counseling Services, LLC
• Elle Marriott

• Clinical Psychologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.