Active NPI
Jerilyn H Silver, MA MSW
- Psychologist
- Espanola, NM
National Provider Identifier
1497865133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- NMI0953
- Practice address
- 600 East Fairview Lane
Espanola, NM 87532 - Phone
- (505) 984-2241
- Fax
- (505) 455-2058
- NPI assigned
- Aug 30, 2006
- 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 | NMI0953 | NM | Primary |
Addresses
Primary practice location
600 East Fairview Lane
Espanola, NM 87532
Mailing address
4001 Office Court Drive
Suite 604
Santa Fe, NM 87507
Phone (505) 984-2241
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040113000139 | NM | Practitioner - Clinical Social Worker | 3173423332 | Practice locations: Los Alamos, NM; Santa Fe, NM |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2610 Trinity Dr
Los Alamos, NM 87544-2376
Phone (505) 984-2241
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NMI0953 | NM | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273708800000",
"number": "1497865133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 OFFICE COURT DRIVE",
"address_2": "SUITE 604",
"city": "SANTA FE",
"state": "NM",
"postal_code": "87507",
"telephone_number": "505-984-2241",
"fax_number": "505-455-2058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 EAST FAIRVIEW LANE",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "87532",
"telephone_number": "505-984-2241",
"fax_number": "505-455-2058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SILVER",
"first_name": "JERILYN",
"middle_name": "H",
"name_prefix": "Mrs.",
"credential": "MA MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2010-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NM",
"license": "NMI0953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Espanola, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.