Individual provider Active NPI

Jack Christopher Carney, PH.D.

  • Psychologist
  • Mobile, AL
National Provider Identifier
1386617512
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1374 Issued in AL
Practice address
2054 Dauphin St
Mobile, AL 36606
Phone
(251) 635-4541
Fax
(251) 217-7933
NPI assigned
Feb 8, 2006
Last updated
Sep 4, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1374 AL Primary

Addresses

Primary practice location

2054 Dauphin St
Mobile, AL 36606

Mailing address

8540 Gayla CT
Mobile, AL 36695-6320
Phone (251) 490-7842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20060405000205 AL Practitioner - Clinical Psychologist 4082622824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1374ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
State of Alabama Dept of Finance Past Accepting new patients
State of Alabama Dept of Finace 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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1386617512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8540 GAYLA CT",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366956320",
            "telephone_number": "251-490-7842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2054 DAUPHIN ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36606",
            "telephone_number": "251-635-4541",
            "fax_number": "251-217-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNEY",
        "first_name": "JACK",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AL",
            "license": "1374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.