Individual provider Active NPI

Jennifer Leann Carter, PHD

  • Psychologist
  • Austin, TX
National Provider Identifier
1669128864
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
33045 Issued in TX
Practice address
3724 Jefferson St Ste 200
Austin, TX 78731-6221
Phone
(512) 779-3859
NPI assigned
Feb 25, 2022
Last updated
Feb 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 33045 TX Primary

Addresses

Primary practice location

3724 Jefferson St Ste 200
Austin, TX 78731-6221

Mailing address

3724 Jefferson St Ste 200
Austin, TX 78731-6221
Phone (512) 779-3859

Other names 1

  • Jennifer Carter Hargrave Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240418003318 TX Practitioner - Psychiatry 9537508882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Center for Therapy and AssessmentGroup PAC ID 0648588061, 8 clinicians

Practice addresses (Care Compare)

5920 W William Cannon Dr
BLDG 6 222
Austin, TX 78749-1909
Phone (512) 282-2282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
33045TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Center for Therapy and Assessment CurrentSince Apr 1, 2024 Accepting new patients

Locations

5920 W William Cannon Dr
Austin, TX 78749
Phone (512) 893-5750

5920 W William Cannon Dr
Bldg 6-222
Austin, TX 78749
Phone (512) 282-2282

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.

NPI Registry JSON

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1669128864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 JEFFERSON ST STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316221",
            "telephone_number": "512-779-3859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3724 JEFFERSON ST STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316221",
            "telephone_number": "512-779-3859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "JENNIFER",
        "middle_name": "LEANN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "33045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HARGRAVE",
            "middle_name": "CARTER",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.