Individual provider Active NPI

Jaimie C Orndorff, PSY.D.

  • Clinical Psychologist
  • Wilmington, NC
National Provider Identifier
1700958071
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4233 Issued in NC
Practice address
4910 Randall Pkwy Ste B
Wilmington, NC 28403-2827
Phone
(910) 515-4556
Fax
(910) 446-3668
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TH0100X
Clinical Social Worker 1041C0700X
Professional Counselor 101YP2500X
Clinical Psychologist 103TC0700X 4233 NC Primary

Addresses

Primary practice location

4910 Randall Pkwy Ste B
Wilmington, NC 28403-2827

Mailing address

4910 Randall Pkwy Ste B
Wilmington, NC 28403-2827
Phone (910) 515-4556

Other identifiers 1

IdentifierTypeStateIssuer
1912545260OtherNPI2

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20120426000386 NC Practitioner - Clinical Psychologist 6608038286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4910 Randall Pkwy
Suite B
Wilmington, NC 28403-2827
Phone (910) 515-4556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4233NCMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Orndorff Psychological Services PLLC Professional CurrentSince Mar 1, 2021 Accepting new patients

Locations

4910 Randall Pkwy
Ste B
Wilmington, NC 28403
Phone (910) 515-4556

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1700958071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 RANDALL PKWY STE B",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032827",
            "telephone_number": "910-515-4556",
            "fax_number": "910-446-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 RANDALL PKWY STE B",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032827",
            "telephone_number": "910-515-4556",
            "fax_number": "910-446-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORNDORFF",
        "first_name": "JAIMIE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI2",
            "identifier": "1912545260",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.