Active NPI
Janette Lynn Funk, PHD
- Psychologist
- Rochester, NY
National Provider Identifier
1477866176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 018667-1
- Practice address
- 1577 South Ave
Rochester, NY 14620-3914 - Phone
- (413) 884-4341
- NPI assigned
- Jul 22, 2010
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 018667-1 | NY | Primary |
Addresses
Primary practice location
1577 South Ave
Rochester, NY 14620-3914
Mailing address
26 Avonmore Way
Penfield, NY 14526-1624
Phone (413) 884-4341
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12130018 | Other | NY | CAQH |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018667-1 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279756800000",
"number": "1477866176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 AVONMORE WAY",
"city": "PENFIELD",
"state": "NY",
"postal_code": "145261624",
"telephone_number": "413-884-4341",
"fax_number": "585-273-1117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1577 SOUTH AVE",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146203914",
"telephone_number": "413-884-4341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNK",
"first_name": "JANETTE",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-22",
"last_updated": "2010-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "018667-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12130018",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.