Individual provider Active NPI

Jennifer Gayle Singleton, PH.D.

  • Psychologist
  • Portland, OR
National Provider Identifier
1427181981
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1047 Issued in OR
Practice address
3415 SW Vista Dr
Portland, OR 97225-2949
Phone
(503) 348-5583
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1047 OR Primary

Addresses

Primary practice location

3415 SW Vista Dr
Portland, OR 97225-2949

Mailing address

3415 SW Vista Dr
Portland, OR 97225-2949
Phone (503) 348-5583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2022 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1047ORMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Stock, PH.D., P.C. Psychologist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1427181981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 SW VISTA DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972252949",
            "telephone_number": "503-348-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 SW VISTA DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972252949",
            "telephone_number": "503-348-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINGLETON",
        "first_name": "JENNIFER",
        "middle_name": "GAYLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "1047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.