Active NPI
Jeremy D Kaufman, PSY.D.
- Clinical Psychologist
- Columbus, OH
National Provider Identifier
1467661579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6339
- Practice address
- 20 S 3Rd St
Ste. 210
Columbus, OH 43215-4206 - Phone
- (614) 636-4779
- NPI assigned
- May 22, 2007
- Last updated
- Jan 10, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6339 | OH | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 6339 | OH | |
| Clinical Psychologist | 103TC0700X | 6339 | OH | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 6339 | OH | |
| Family Psychologist | 103TF0000X | 6339 | OH | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 6339 | OH |
Addresses
Primary practice location
20 S 3Rd St
Ste. 210
Columbus, OH 43215-4206
Mailing address
20 S 3Rd St
Ste. 210
Columbus, OH 43215-4206
Phone (614) 636-4779
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6339 | OH | MD | Family Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484006400000",
"number": "1467661579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 S 3RD ST",
"address_2": "STE. 210",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432154206",
"telephone_number": "614-636-4779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 S 3RD ST",
"address_2": "STE. 210",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432154206",
"telephone_number": "614-636-4779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFMAN",
"first_name": "JEREMY",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2017-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "6339",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "OH",
"license": "6339",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "6339",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "OH",
"license": "6339",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "OH",
"license": "6339",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "OH",
"license": "6339",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.