Individual provider Active NPI

Jill Teresa Caffrey, PH.D.

  • Clinical Neuropsychologist
  • Tucson, AZ
National Provider Identifier
1669514758
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
2023 Issued in AZ
Practice address
403 W Cool Dr Ste 107
Tucson, AZ 85704
Phone
(520) 329-8298
Fax
(520) 329-8311
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2023 AZ
Clinical Neuropsychologist 103G00000X 2023 AZ Primary

Addresses

Primary practice location

403 W Cool Dr Ste 107
Tucson, AZ 85704

Mailing address

403 W Cool Dr Ste 107
Tucson, AZ 85704-6551
Phone (520) 329-8298

Other practice location 1

1845 W Orange Grove Rd Suite 111
Tucson, AZ 85704
Phone (520) 329-8298

Other identifiers 4

IdentifierTypeStateIssuer
P00646501OtherAZMEDICARE RAILROAD
186644MedicaidAZ
5385585OtherAZAETNA
236799OtherAZMANAGED HEALTH NETWORK

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2023AZMDNeurology Physician

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15044/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1669514758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W COOL DR STE 107",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857046551",
            "telephone_number": "520-329-8298",
            "fax_number": "520-329-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W COOL DR STE 107",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85704",
            "telephone_number": "520-329-8298",
            "fax_number": "520-329-8311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1845 W Orange Grove Rd Suite 111",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "85704",
            "country_code": "US",
            "telephone_number": "520-329-8298",
            "fax_number": "520-329-8311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAFFREY",
        "first_name": "JILL",
        "middle_name": "TERESA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "2023",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "2023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00646501",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186644",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5385585",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "236799",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.