Individual provider Active NPI

Jamila Nayo Codrington

  • Clinical Child & Adolescent Psychologist
  • Bronx, NY
National Provider Identifier
1487835765
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
017350 Issued in NY
Practice address
750 Tilden St
Bronx, NY 10467-6013
Phone
(718) 231-3400
Fax
(718) 655-3503
NPI assigned
Nov 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 017350 NY Primary

Addresses

Primary practice location

750 Tilden St
Bronx, NY 10467-6013

Mailing address

750 Tilden St
Bronx, NY 10467-6013
Phone (718) 231-3400

Other identifiers 1

IdentifierTypeStateIssuer
00245029MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20201205000034 NY Order and Referring Only - Clinical Psychologist 1951712439

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1487835765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 TILDEN ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104676013",
            "telephone_number": "718-231-3400",
            "fax_number": "718-655-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 TILDEN ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104676013",
            "telephone_number": "718-231-3400",
            "fax_number": "718-655-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CODRINGTON",
        "first_name": "JAMILA",
        "middle_name": "NAYO",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "017350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00245029",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.