Jacquelyn M Zavodnick, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD015911E Issued in PA

Practice address

1041 W Bridge St
Stes 1 & 2, Devereux Beneto Ctr Comm SVCS Devereux
Phoenixville, PA 19460

Phone

(610) 933-8110

Fax

(610) 296-5866

NPI assigned

Jun 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• The Devereux Foundation

  • Community/Behavioral Health Agency
  • Malvern, PA
  • NPI 1881777118
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740218510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 OAKWOOD DR",
            "address_2": "N122",
            "city": "NARBERTH",
            "state": "PA",
            "postal_code": "190721017",
            "telephone_number": "610-668-9997",
            "fax_number": "610-296-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 W BRIDGE ST",
            "address_2": "STES 1 & 2, DEVEREUX BENETO CTR COMM SVCS DEVEREUX",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "19460",
            "telephone_number": "610-933-8110",
            "fax_number": "610-296-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAVODNICK",
        "first_name": "JACQUELYN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD015911E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005544390339",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Zalaffi
• Emily Ann Zamojski
• Shayne Aubrey Zaplitny
• Raza Zarrar, M.B.B.S., M.D.
• Kari Ann Zarynow
• Dara Marie Zavodny, M.ED
• Stacey Zehren, LCSW
• Sharon L Zellis, DO
• Claire Louise Zeranski
• Ying Zhang, PHARM D

• Child & Adolescent Psychiatry Physician in Phoenixville, PA
• Providers in Phoenixville, PA by specialty
• Child & Adolescent Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.