Active NPI
Jayne Gordon, PH.D.
- Psychologist
- San Antonio, TX
National Provider Identifier
1386655900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 24271
- Practice address
- 1602 N Loop 1604 W
Suite LL-102
San Antonio, TX 78248-4513 - Phone
- (210) 479-3231
- Fax
- (210) 493-7273
- NPI assigned
- Aug 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 24271 | TX | Primary |
Addresses
Primary practice location
1602 N Loop 1604 W
Suite LL-102
San Antonio, TX 78248-4513
Mailing address
35 Devon Wood
San Antonio, TX 78257-1212
Phone (210) 698-5561
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 044047 | Other | TX | VALUE OPTIONS |
| G35Y | Other | TX | BLUE CROSS BLUE SHIELD OF |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24271 | TX | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Turning Points | Past | Accepting new patients | |
| Turning Points | Past | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- San Antonio, TX
- NPI 1013039726
-
- Clinical Social Worker
- San Antonio, TX
- NPI 1841606019
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386655900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 DEVON WOOD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782571212",
"telephone_number": "210-698-5561",
"fax_number": "210-698-2668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1602 N LOOP 1604 W",
"address_2": "SUITE LL-102",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782484513",
"telephone_number": "210-479-3231",
"fax_number": "210-493-7273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "JAYNE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "24271",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "044047",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF",
"identifier": "G35Y",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.