Individual provider Active NPI

Joellyn L Ross, PH.D.

  • Psychologist
  • Cherry Hill, NJ
National Provider Identifier
1457356115
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
S101780 Issued in NJ
Practice address
1930 Marlton Pike E
Ste J49
Cherry Hill, NJ 08003-4106
Phone
(856) 424-1965
NPI assigned
Jun 17, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X S101780 NJ Primary
Psychologist 103T00000X PS003952 PA

Addresses

Primary practice location

1930 Marlton Pike E
Ste J49
Cherry Hill, NJ 08003-4106

Mailing address

1930 Marlton Pike E
Ste J49
Cherry Hill, NJ 08003-4106
Phone (856) 424-1965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20080613000442 NJ Practitioner - Clinical Psychologist 2163593484 Practice locations: Cherry Hill, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Temple University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1930 E Marlton Pike
Suite J 49
Cherry Hill, NJ 08003-4106

1930 Marlton Pike E
Cherry Hill, NJ 08003-4106
Phone (856) 424-1065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S101780NJMDPsychologist
PS003952PAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1457356115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 MARLTON PIKE E",
            "address_2": "STE J49",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080034106",
            "telephone_number": "856-424-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 MARLTON PIKE E",
            "address_2": "STE J49",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080034106",
            "telephone_number": "856-424-1965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JOELLYN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "S101780",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS003952",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.