Individual provider Active NPI

Dallas James Webb, PSY.D.

  • Clinical Psychologist
  • Jacksonville, FL
National Provider Identifier
1720709314
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY11621 Issued in FL
Practice address
1660 Prudential Dr Ste 410
Jacksonville, FL 32207-8197
Phone
(904) 376-3800
NPI assigned
Sep 12, 2022
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY11621 FL Primary

Addresses

Primary practice location

1660 Prudential Dr Ste 410
Jacksonville, FL 32207-8197

Mailing address

PO Box 748519
Atlanta, GA 30374-8519
Phone (904) 376-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20221007001046 FL Practitioner - Clinical Psychologist 6002292422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Behavioral Health LLCGroup PAC ID 7315166394, 120 clinicians

Practice addresses (Care Compare)

1660 Prudential Dr
Suite 410
Jacksonville, FL 32207-8197
Phone (904) 376-3800

Merit-based Incentive Payment System (MIPS)

Final score
89.95 of 100Reported as group
Quality
84.69
Promoting interoperability
100
Improvement activities
40
Cost
74.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY11621FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Behavioral Health, LLC CurrentSince Oct 7, 2022 Accepting new patients
Southern Baptist Hospital of Florida Inc Past Accepting new patients

Locations

1660 Prudential Dr
Ste 410
Jacksonville, FL 32207

820 Prudential Dr
Ste 510
Jacksonville, FL 32207

836 Prudential Dr
Ste 1006
Jacksonville, FL 32207
Phone (904) 202-1795

87010 Professional Way
Yulee, FL 32097

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1720709314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748519",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748519",
            "telephone_number": "904-376-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 PRUDENTIAL DR STE 410",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078197",
            "telephone_number": "904-376-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "DALLAS",
        "middle_name": "JAMES",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-12",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY11621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.