Active NPI
Jill L Ricke, PH.D.
- Psychologist
- Tallahassee, FL
National Provider Identifier
1508900580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY0004423
- Practice address
- 1535 Killearn Center Blvd
Suite D-1
Tallahassee, FL 32309-3467 - Phone
- (850) 877-6011
- Fax
- (850) 893-6013
- NPI assigned
- Feb 16, 2007
- 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 | PY0004423 | FL | Primary |
Addresses
Primary practice location
1535 Killearn Center Blvd
Suite D-1
Tallahassee, FL 32309-3467
Mailing address
PO Box 15755
Tallahassee, FL 32317-5755
Phone (850) 877-6011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 73698 | Other | FL | BLUE CROSS BLUE SHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PY0004423 | FL | MD | Psychologist |
| 4423 | FL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508900580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 15755",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323175755",
"telephone_number": "850-877-6011",
"fax_number": "850-893-6013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1535 KILLEARN CENTER BLVD",
"address_2": "SUITE D-1",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323093467",
"telephone_number": "850-877-6011",
"fax_number": "850-893-6013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICKE",
"first_name": "JILL",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY0004423",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "73698",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.