Organization Active NPI

Janon Strom, PH.D., P.a.

  • Clinical Psychologist
  • Fort Lauderdale, FL
National Provider Identifier
1649531492
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 4268 Issued in FL
Legal business name
JANON STROM, PH.D., P.A.
Practice address
6499 Powerline Rd
Suite 209
Fort Lauderdale, FL 33309-2069
Phone
(954) 772-6677
Fax
(954) 772-6711
NPI assigned
Jun 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Authorized official

Name
Janon Strom, PH.D.NPI 1720161102
Title
Owner
Phone
(954) 772-6677

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY 4268 FL Primary

Addresses

Primary practice location

6499 Powerline Rd
Suite 209
Fort Lauderdale, FL 33309-2069

Mailing address

6499 Powerline Rd
Suite 209
Fort Lauderdale, FL 33309-2069
Phone (954) 772-6677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120829000445 FL Part B Supplier - Clinic/Group Practice 7012164841 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Lauderdale, FL; Ft Lauderdale, FL

National Provider Directory

National Provider Directory

Locations

2900 E Oakland Park Blvd
Fl 3
Ft Lauderdale, FL 33306
Phone (954) 361-5470

2200 NE 26th St
Ste E
Wilton Manors, FL 33305
Phone (954) 564-4333

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339545600000",
    "number": "1649531492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6499 POWERLINE RD",
            "address_2": "SUITE 209",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333092069",
            "telephone_number": "954-772-6677",
            "fax_number": "954-772-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6499 POWERLINE RD",
            "address_2": "SUITE 209",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333092069",
            "telephone_number": "954-772-6677",
            "fax_number": "954-772-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANON STROM, PH.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-13",
        "status": "A",
        "authorized_official_last_name": "STROM",
        "authorized_official_first_name": "JANON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-772-6677",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 4268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.