Jacquelyn Erlene Flood, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY7586 Issued in FL

Practice address

262 Crystal Grove Blvd
Lutz, FL 33548-6460

Phone

(813) 326-5915

NPI assigned

Mar 3, 2008

Last updated

Oct 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: jflood150920@direct.tgh.org

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.

• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• PA Sprout MC 1 LLC

  dba Elemy

  • Behavior Analyst
  • Doylestown, PA
  • NPI 1528687092
  NPD (past)
• St Health TX, P.a.

  • Clinical Psychologist
  • New York, NY
  • NPI 1982476685
  NPD (past)
• Wa MC Sprout 1 LLC

  dba Elemy

  • Behavior Analyst
  • Seattle, WA
  • NPI 1881213429
  NPD (past)

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1548430960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 CRYSTAL GROVE BLVD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335486460",
            "telephone_number": "813-326-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOOD",
        "first_name": "JACQUELYN",
        "middle_name": "ERLENE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "40267",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5933D",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "768739700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jflood150920@direct.tgh.org",
            "affiliation": "N",
            "address_1": "262 Crystal Grove Blvd",
            "city": "Lutz",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335486460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brianna Flair, BSN, RN
• Jefrey I Fleming, RPH
• Jennifer Lee Fleming, APRN
• Mark Fleming
• Johanna J Flicker, M.S. CCC-SLP
• Sheila M Flores
• Florida Autism Center
• Florida Family Psychiatry, LLC (Florida Family Psychiatry)
• Florida Medical Clinic, LLC
• Florida Pain and Rehabilitation Associates Inc (B3 Medical)

• Clinical Psychologist in Lutz, FL
• Providers in Lutz, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.