Donna Jackson

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

8102 Issued in MA

Practice address

155 Katherine Lee Bates Rd # 21
Falmouth, MA 02540-2845

Phone

(774) 454-3290

NPI assigned

Feb 8, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Limbic Resources Inc

  • Mental Health Counselor
  • East Falmouth, MA
  • NPI 1063899060
  Medicare reassignment NPD

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

{
    "created_epoch": "1391817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391817600000",
    "number": "1679997837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 KATHERINE LEE BATES RD # 21",
            "city": "FALMOUTH",
            "state": "MA",
            "postal_code": "025402845",
            "telephone_number": "774-454-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 KATHERINE LEE BATES RD # 21",
            "city": "FALMOUTH",
            "state": "MA",
            "postal_code": "025402845",
            "telephone_number": "774-454-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "DONNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-08",
        "last_updated": "2014-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "8102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Davis Hutchinson, DMD
• Maria Josephine Iacozza, CASE MANAGER
• Rylie Indio
• Thomas William Irvine, M.D.
• J & C Gagnon DMD PC
• Segreena Jackson, RPH
• Simon Jacobs, MD
• Donna Jalette, OTR
• James C. Alban M.D. PC
• Kerri Elizabeth Jenkins

• Clinical Psychologist in Falmouth, MA
• Providers in Falmouth, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2014; 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.

Verify at the official NPI Registry.