Jayne M Dubois, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P0000001925 Issued in TN

Practice address

6110 Shallowford Rd
C/O CRC
Chattanooga, TN 37421-1894

Phone

(800) 632-6074

NPI assigned

Oct 8, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jayne M Fiedler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234915200000",
    "number": "1427209451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7431 114TH AVE",
            "address_2": "SUITE 104",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337735119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 SHALLOWFORD RD",
            "address_2": "C/O CRC",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211894",
            "telephone_number": "800-632-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOIS",
        "first_name": "JAYNE",
        "middle_name": "M",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2009-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P0000001925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508707",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAYNE",
            "last_name": "FIEDLER",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William D Drinnon, MD
• Jonathan Aaron Drumm I, FNP
• Heather Ann Harrison Dryden, LMFT
• DT Transportation
• Annesofie K Dubeck-Brooks, MD
• Emma Dubose, MA, MFT-I
• Serenity Shea Duckett
• Don D Duff, FNP-C
• Donna Reed Duff, FNP-C
• Siobhan Duff, MD

• Clinical Psychologist in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.