Active NPI
Janis Dawn Buffaloe, PSY.D.
- Clinical Psychologist
- Fort Stewart, GA
National Provider Identifier
1396745667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY 4366
- Practice address
- 1601 Harmon Ave
Ste 1D03 Winn Army Community Hospital
Fort Stewart, GA 31314-5674 - Phone
- (912) 767-7301
- NPI assigned
- Jul 28, 2005
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY 4366 | FL | Primary |
Addresses
Primary practice location
1601 Harmon Ave
Ste 1D03 Winn Army Community Hospital
Fort Stewart, GA 31314-5674
Mailing address
1601 Harmon Ave
Ste 1D03 Winn Army Community Hospital
Fort Stewart, GA 31314-5674
Phone (912) 767-7301
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 4366 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285718400000",
"number": "1396745667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 HARMON AVE",
"address_2": "STE 1D03 WINN ARMY COMMUNITY HOSPITAL",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "313145674",
"telephone_number": "912-767-7301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 HARMON AVE",
"address_2": "STE 1D03 WINN ARMY COMMUNITY HOSPITAL",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "313145674",
"telephone_number": "912-767-7301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUFFALOE",
"first_name": "JANIS",
"middle_name": "DAWN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-28",
"last_updated": "2010-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY 4366",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Stewart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.