Individual provider Active NPI

Jason Andrew Demery, PHD

  • Clinical Neuropsychologist
  • Gainesville, FL
National Provider Identifier
1700077724
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY7500 Issued in FL
Practice address
8491 NW 39TH Ave
Uf Springhill Health Center
Gainesville, FL 32606-5635
Phone
(352) 265-3284
Fax
(352) 265-3285
NPI assigned
Aug 6, 2007
Last updated
Jan 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY7500 FL Primary
Clinical Psychologist 103TC0700X PY7500 FL

Addresses

Primary practice location

8491 NW 39TH Ave
Uf Springhill Health Center
Gainesville, FL 32606-5635

Mailing address

8491 NW 39TH Ave
Uf Springhill Health Center
Gainesville, FL 32606-5635
Phone (352) 265-3284

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY7500FLMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295308800000",
    "number": "1700077724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8491 NW 39TH AVE",
            "address_2": "UF SPRINGHILL HEALTH CENTER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326065635",
            "telephone_number": "352-265-3284",
            "fax_number": "352-265-3285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8491 NW 39TH AVE",
            "address_2": "UF SPRINGHILL HEALTH CENTER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326065635",
            "telephone_number": "352-265-3284",
            "fax_number": "352-265-3285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMERY",
        "first_name": "JASON",
        "middle_name": "ANDREW",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2011-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY7500",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; 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.