Active NPI
Jason Linticum
- School Psychologist
- Evans, GA
National Provider Identifier
1659063352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- Practice address
- 145 Canton Park Ave
Evans, GA 30809-0808 - Phone
- (706) 421-2464
- NPI assigned
- May 22, 2023
- Last updated
- May 22, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | NU | Primary |
Addresses
Primary practice location
145 Canton Park Ave
Evans, GA 30809-0808
Mailing address
145 Canton Park Ave
Evans, GA 30809-0808
Phone (706) 421-2464
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684713600000",
"number": "1659063352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 CANTON PARK AVE",
"city": "EVANS",
"state": "GA",
"postal_code": "308090808",
"telephone_number": "706-421-2464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 CANTON PARK AVE",
"city": "EVANS",
"state": "GA",
"postal_code": "308090808",
"telephone_number": "706-421-2464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LINTICUM",
"first_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-22",
"last_updated": "2023-05-22",
"certification_date": "2023-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evans, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.