Jerald W Bamburg Jr., PH.D.

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

License

951 Issued in LA

Practice address

106 N Bend Dr
Pineville, LA 71360-4677

Phone

(318) 442-4498

NPI assigned

Jun 20, 2008

Last updated

Jan 11, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Bamburg Consulting, Inc.

  • Clinical Psychologist
  • Pineville, LA
  • NPI 1083862353
  Authorized official Same address or phone

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1598926644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 N BEND DR",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604677",
            "telephone_number": "318-442-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 N BEND DR",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604677",
            "telephone_number": "318-442-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMBURG",
        "first_name": "JERALD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "LA",
            "license": "951",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "LA",
            "license": "951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlie Hirchak Baker, RDN, LDN
• Emily Anne Baker
• Julie C Baker, PT
• Kathy Hebert Baldridge, FNP
• Bamburg Consulting, Inc.
• Pamela R Bankston, M.S., CCC-SLP
• William Calvit Bankston Jr., LCSW
• Laurie Michelle Bardwell, LCSW
• Jerrie Barfield, LDN, RD
• Alan L. Barnes, M.D.

• Intellectual & Developmental Disabilities Psychologist in Pineville, LA
• Providers in Pineville, LA by specialty
• Intellectual & Developmental Disabilities Psychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.