Individual provider Active NPI

Jayne Rubendall, ED.S.

  • School Psychologist
  • Mitchell, SD
National Provider Identifier
1730530593
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
62759-1 Issued in SD
Practice address
1421 N Capital St
Mitchell, SD 57301-1152
Phone
(605) 996-4634
NPI assigned
Jun 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 62759-1 SD Primary

Addresses

Primary practice location

1421 N Capital St
Mitchell, SD 57301-1152

Mailing address

1421 N Capital St
Mitchell, SD 57301-1152
Phone (605) 996-4634

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

State licenses

LicenseStateTypeSpecialty
62759-1SDMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1730530593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 N CAPITAL ST",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573011152",
            "telephone_number": "605-996-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 N CAPITAL ST",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573011152",
            "telephone_number": "605-996-4634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBENDALL",
        "first_name": "JAYNE",
        "credential": "ED.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "SD",
            "license": "62759-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.