Active NPI
Jensi Gise, PHD
- Clinical Psychologist
- Atlanta, GA
National Provider Identifier
1689343782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY004838
- Practice address
- 140 Decatur St SE
Atlanta, GA 30303-3204 - Phone
- (404) 413-6229
- NPI assigned
- Sep 10, 2021
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY004838 | GA | Primary |
Addresses
Primary practice location
140 Decatur St SE
Atlanta, GA 30303-3204
Mailing address
140 Decatur St SE
Atlanta, GA 30303-3204
Phone (404) 413-6229
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250115001844 | GA | Order and Referring Only - Other (Non-Physician) | 1759819980 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY004838 | GA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730246400000",
"number": "1689343782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 DECATUR ST SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303033204",
"telephone_number": "404-413-6229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 DECATUR ST SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303033204",
"telephone_number": "404-413-6229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GISE",
"first_name": "JENSI",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-10",
"last_updated": "2024-10-30",
"certification_date": "2024-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY004838",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.