Individual provider Active NPI

Jennifer M. Gillette

  • Clinical Psychologist
  • Davie, FL
National Provider Identifier
1578855698
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 8276 Issued in FL
Practice address
10650 W State Road 84 Ste 211
Davie, FL 33324-4235
Phone
(954) 257-0711
NPI assigned
May 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY 8276 FL Primary
Clinical Neuropsychologist 103G00000X PY 8276 FL

Addresses

Primary practice location

10650 W State Road 84 Ste 211
Davie, FL 33324-4235

Mailing address

3790 SW 106TH Ter
Davie, FL 33328-1309
Phone (954) 257-0711

Other names 1

  • Dba: Gillette Neuropsychology LLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110812000581 FL Practitioner - Clinical Psychologist 0345419073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sailor Health Medical PAGroup PAC ID 4486182342, 301 clinicians

Practice addresses (Care Compare)

201 S Biscayne Blvd
Suite 2867
Miami, FL 33131-4330
Phone (786) 269-0333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY 8276FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gillette Neuropsychology, LLC Clinical Neuropsychologist 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1304812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1578855698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3790 SW 106TH TER",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333281309",
            "telephone_number": "954-257-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10650 W STATE ROAD 84 STE 211",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333244235",
            "telephone_number": "954-257-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "JENNIFER",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-08",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 8276",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY 8276",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DBA: GILLETTE NEUROPSYCHOLOGY",
            "last_name": "LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.