Individual provider Active NPI

Jennifer L. Huffman, PHD

  • Clinical Neuropsychologist
  • East Lansing, MI
National Provider Identifier
1508819699
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
6301011260 Issued in MI
Practice address
4572 S Hagadorn Rd
Suite 2G
East Lansing, MI 48823-5385
Phone
(517) 337-9554
Fax
(517) 337-9545
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 6301011260 MI Primary

Addresses

Primary practice location

4572 S Hagadorn Rd
Suite 2G
East Lansing, MI 48823-5385

Mailing address

4572 S Hagadorn Rd
Suite 2G
East Lansing, MI 48823-5385
Phone (517) 337-9554

Other identifiers 1

IdentifierTypeStateIssuer
680C31232OtherMIBLUE SHIELD OF MICHIGAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040426001735 MI Practitioner - Clinical Psychologist 9537156245 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4572 S Hagadorn Rd
East Lansing, MI 48823-5385
Phone (517) 337-9554

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
W. a. Foote Memorial Hospital, Inc. CurrentSince Apr 10, 2003 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Apr 10, 2003 Accepting new patients
Huffman Psychology, PLLC Clinical Neuropsychologist CurrentSince Jan 1, 2004 Accepting new patients
Henry Ford Pathology Current Accepting new patients

Locations

4572 S Hagadorn Rd
Ste 2G
East Lansing, MI 48823
Phone (517) 337-9554

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

1400 E Michigan Ave
Jackson, MI 49202
Phone (517) 314-2990

Organizations & group practices 4

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1508819699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4572 S HAGADORN RD",
            "address_2": "SUITE 2G",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235385",
            "telephone_number": "517-337-9554",
            "fax_number": "517-337-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4572 S HAGADORN RD",
            "address_2": "SUITE 2G",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235385",
            "telephone_number": "517-337-9554",
            "fax_number": "517-337-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUFFMAN",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301011260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MICHIGAN",
            "identifier": "680C31232",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.