Neil Allen Jepson, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0470000715 Issued in VT

Practice address

1111 Trinity LN Ste 111
Bloomington, IL 61704-8112

Phone

(309) 663-6461

NPI assigned

Aug 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Carle West Physician Group Inc

  • Family Medicine Physician
  • Normal, IL
  • NPI 1467074138
  Medicare reassignment Care Compare group NPD
• Edgewood Clinical Services, P.C.

  • Psychologist
  • Naperville, IL
  • NPI 1295914646
  NPD (past)
• University of Vermont Medical Center Inc

  • Internal Medicine Physician
  • Burlington, VT
  • NPI 1659309615
  NPD (past)

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1689687709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 TRINITY LN STE 111",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048112",
            "telephone_number": "309-663-6461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "441 Water Tower Circle",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Colchester",
            "state": "VT",
            "postal_code": "05446",
            "country_code": "US",
            "telephone_number": "802-310-7763",
            "fax_number": "802-655-1115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEPSON",
        "first_name": "NEIL",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "047000715",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "VT",
            "license": "0470000715",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "0470000715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010983",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandria Jasso
• Laurie Marie Jeans
• Jen Guidebeck LCSW, PLLC
• Jen Woodrum Counseling PLLC
• Kenyatta Ameer Jenkins, ATC
• Won Jhee
• Lucia Jiardina
• Sinata Becca Jinadu
• Jody Seip Counseling
• Stephanie Anne Johansson, LCSW

• Clinical Psychologist in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.