Individual provider Active NPI

Jamie Michelle King, PH.D.

  • Psychologist
  • Greensburg, PA
National Provider Identifier
1497743199
Registry record updated May 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS017392 Issued in PA
Practice address
1275 S Main St Ste 101
Greensburg, PA 15601-5385
Phone
(724) 221-6394
Fax
(724) 420-5593
NPI assigned
Oct 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS017392 PA Primary

Addresses

Primary practice location

1275 S Main St Ste 101
Greensburg, PA 15601-5385

Mailing address

1275 S Main St Ste 101
Greensburg, PA 15601-5385
Phone (724) 221-6394

Other identifiers 1

IdentifierTypeStateIssuer
102843952MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20140509001916 PA Practitioner - Clinical Psychologist 8123251527 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS017392PAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Jamie King the Ctr for Psychological SVC & Life Coach, LLC Psychologist CurrentSince May 16, 2017 Accepting new patients

Locations

430 Pellis Rd
Ste 201
Greensburg, PA 15601
Phone (724) 221-6394

1275 S Main St
Ste 101
Greensburg, PA 15601
Phone (724) 221-6394

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684022400000",
    "number": "1497743199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 S MAIN ST STE 101",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156015385",
            "telephone_number": "724-221-6394",
            "fax_number": "724-420-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 S MAIN ST STE 101",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156015385",
            "telephone_number": "724-221-6394",
            "fax_number": "724-420-5593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JAMIE",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-07",
        "last_updated": "2023-05-14",
        "certification_date": "2023-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS017392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102843952",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensburg, PA

Sources for this page

Verify at the official NPI Registry.