Individual provider Active NPI

Judith Ellen Pierson, ED.D.

  • Psychologist
  • Rehoboth Beach, DE
National Provider Identifier
1386685543
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
7135 Issued in MA
Practice address
715 Rehoboth Ave
#11
Rehoboth Beach, DE 19971-3100
Phone
(302) 227-6745
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 7135 MA Primary

Addresses

Primary practice location

715 Rehoboth Ave
#11
Rehoboth Beach, DE 19971-3100

Mailing address

100 Henlopen Sta
Unit 305a
Rehoboth Beach, DE 19971-3188
Phone (302) 227-6745

Other identifiers 5

IdentifierTypeStateIssuer
5454616OtherMAAETNA HEALTH INSURANCE PL
87726OtherMAUNITED BEHAVIORAL HEALTH
232584OtherMAMANAGED HEALTH NETWORK
391192OtherMAMAGELLAN BEHAVIORAL HEALT
W05749OtherMABLUE CROSS / BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20080305000128 DE Practitioner - Clinical Psychologist 7012092794 Practice locations: Rehoboth Beach, DE

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

57 Tiffany Dr
Rehoboth Beach, DE 19971-9729
Phone (302) 519-9771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7135MAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1386685543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HENLOPEN STA",
            "address_2": "UNIT 305A",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199713188",
            "telephone_number": "302-227-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 REHOBOTH AVE",
            "address_2": "#11",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199713100",
            "telephone_number": "302-227-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERSON",
        "first_name": "JUDITH",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "7135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTH INSURANCE PL",
            "identifier": "5454616",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "87726",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "232584",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALT",
            "identifier": "391192",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "W05749",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rehoboth Beach, DE

Sources for this page

Verify at the official NPI Registry.