Individual provider Active NPI

Jason Paul Alan Gallant, PH.D., LP

  • Psychologist
  • Winter Park, FL
National Provider Identifier
1508170432
Registry record updated Feb 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
8558 Issued in FL
Practice address
7001 University Blvd
Winter Park, FL 32792-6719
Phone
(407) 853-7700
Fax
(407) 853-7739
NPI assigned
Aug 3, 2010
Last updated
Feb 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 8558 FL Primary

Addresses

Primary practice location

7001 University Blvd
Winter Park, FL 32792-6719

Mailing address

7001 University Blvd
Winter Park, FL 32792-6719
Phone (407) 853-7700

Other identifiers 1

IdentifierTypeStateIssuer
029959604MedicaidFL

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
8558FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jason Gallant, PH.D., LLC Current Accepting new patients
Boys Town of Central Florida, Inc. Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1508170432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 UNIVERSITY BLVD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327926719",
            "telephone_number": "407-853-7700",
            "fax_number": "407-853-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 UNIVERSITY BLVD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327926719",
            "telephone_number": "407-853-7700",
            "fax_number": "407-853-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLANT",
        "first_name": "JASON",
        "middle_name": "PAUL ALAN",
        "credential": "PH.D., LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-03",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "8558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029959604",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.