Active NPI
Jason Lagory, PH.D.
- Clinical Psychologist
- Little Rock, AR
National Provider Identifier
1679726533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 10-18P
- Practice address
- 11 Childrens Way
Slot 654
Little Rock, AR 72202-3500 - Phone
- (501) 364-5150
- Fax
- (501) 364-1592
- NPI assigned
- Oct 23, 2008
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 10-18P | AR | Primary |
Addresses
Primary practice location
11 Childrens Way
Slot 654
Little Rock, AR 72202-3500
Mailing address
11 Childrens Way
Slot 654
Little Rock, AR 72202-3500
Phone (501) 364-5150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 170484795 | Medicaid | AR |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282089600000",
"number": "1679726533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 CHILDRENS WAY",
"address_2": "SLOT 654",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722023500",
"telephone_number": "501-364-5150",
"fax_number": "501-364-1592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 CHILDRENS WAY",
"address_2": "SLOT 654",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722023500",
"telephone_number": "501-364-5150",
"fax_number": "501-364-1592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAGORY",
"first_name": "JASON",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-23",
"last_updated": "2010-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AR",
"license": "10-18P",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "170484795",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.