NPIMap

Organization Active NPI

Palm Beach Psychology Group, LLC

  • Clinical Psychologist
  • Boca Raton, FL
National Provider Identifier
1487085809
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
PALM BEACH PSYCHOLOGY GROUP, LLC
Practice address
9970 Central Park Blvd N
Sutie 207
Boca Raton, FL 33428-2231
Phone
(561) 245-4622
NPI assigned
Dec 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Authorized official

Name
Dr. Meghan K Jacobs, PSY.D.NPI 1457650673
Title
Co-Owner/ Psychologist
Phone
(561) 245-4622

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

9970 Central Park Blvd N
Sutie 207
Boca Raton, FL 33428-2231

Mailing address

9970 Central Park Blvd N
Sutie 207
Boca Raton, FL 33428-2231
Phone (561) 245-4622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140521000674 FL Part B Supplier - Clinic/Group Practice 6709009756 Receives reassigned benefits from 4 practitioners
Practice locations: Boca Raton, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397692800000",
    "number": "1487085809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9970 CENTRAL PARK BLVD N",
            "address_2": "SUTIE 207",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334282231",
            "telephone_number": "561-245-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9970 CENTRAL PARK BLVD N",
            "address_2": "SUTIE 207",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334282231",
            "telephone_number": "561-245-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BEACH PSYCHOLOGY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-11",
        "last_updated": "2014-04-17",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "MEGHAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CO-OWNER/ PSYCHOLOGIST",
        "authorized_official_telephone_number": "561-245-4622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.