Active NPI
Debra J Jedd, PSYD
- Psychologist
- Champaign, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 071006849
- Practice address
- 1813 W. Kirby Avenue
Psychiatry/Psychology
Champaign, IL 61821 - Phone
- (217) 383-1850
- Fax
- (217) 383-3439
- NPI assigned
- Jul 7, 2006
- Last updated
- May 26, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 071006849 | IL | Primary |
Addresses
Primary practice location
1813 W. Kirby Avenue
Psychiatry/Psychology
Champaign, IL 61821
Mailing address
611 W Park St
BWPC
Urbana, IL 61801-2529
Phone (217) 383-6792
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1802 S Mattis Ave
Champaign, IL 61821-5923
Phone (217) 326-1330
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071006849 | IL | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carle Health Medical Group | Current | Accepting new patients |
Locations
1813 W Kirby Ave
Champaign, IL 61821
Phone (217) 383-1850
1802 S Mattis Ave
Champaign, IL 61821
Phone (217) 365-2855
1001 Heather Dr
Mahomet, IL 61853
Phone (217) 586-2317
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Organizations & group practices 1
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.
-
dba Carle Physician Group
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432598400000",
"number": "1659303063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 W PARK ST",
"address_2": "BWPC",
"city": "URBANA",
"state": "IL",
"postal_code": "618012529",
"telephone_number": "217-383-6792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1813 W. KIRBY AVENUE",
"address_2": "PSYCHIATRY/PSYCHOLOGY",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "61821",
"telephone_number": "217-383-1850",
"fax_number": "217-383-3439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEDD",
"first_name": "DEBRA",
"middle_name": "J",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-07",
"last_updated": "2015-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": "071006849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Champaign, IL
- Rachel Michelle Jankiewicz, M.A., CCC-SLP
- Japhia Hannah Jayasingh-Ramkumar, M.D.
- Jbe Transport and Logistics
- Richard Jean, A.T.C.
- Lawrence Lee Jeckel, M.D.
- Casey Lynn Jenkins
- Doris Jenkins
- Tiffany Keisha Jenkins, PHD, NCSP
- Amy Jessup, NP
- Jim Hamilton Counseling and Therapy Company (Hamilton Counseling and Therapy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.