Individual provider Active NPI

Jennifer Lee Sapia, PHD

  • Psychologist
  • Southport, NC
National Provider Identifier
1396739215
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2727 Issued in NC
Practice address
4320 Southport Supply Rd SE
Suite 400
Southport, NC 28461-8158
Phone
(910) 457-0800
Fax
(910) 457-1072
NPI assigned
Sep 7, 2005
Last updated
Mar 21, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2727 NC Primary

Addresses

Primary practice location

4320 Southport Supply Rd SE
Suite 400
Southport, NC 28461-8158

Mailing address

4320 Southport Supply Rd SE
Suite 400
Southport, NC 28461-8158
Phone (910) 457-0800

Other identifiers 3

IdentifierTypeStateIssuer
046RGOtherNCBCBS
045MGOtherNCBCBS NC
6000172MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20040713001159 NC Practitioner - Clinical Psychologist 7810975018 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2727NCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sapia Psychological Associates Inc. CurrentSince Nov 1, 2006 Accepting new patients
Health-Pro Mental Health Services PLLC Past Accepting new patients
P & S Med Past Accepting new patients

Locations

4320 Southport Supply Rd SE
Ste 200
Southport, NC 28461
Phone (910) 457-0800

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1396739215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 SOUTHPORT SUPPLY RD SE",
            "address_2": "SUITE 400",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284618158",
            "telephone_number": "910-457-0800",
            "fax_number": "910-457-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 SOUTHPORT SUPPLY RD SE",
            "address_2": "SUITE 400",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284618158",
            "telephone_number": "910-457-0800",
            "fax_number": "910-457-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAPIA",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-07",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "2727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "046RG",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "045MG",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000172",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, NC

Sources for this page

Verify at the official NPI Registry.