Jay E Earles, PSYD

Primary specialty

Health PsychologistTaxonomy code 103TH0004X

License

1469 Issued in SC

Practice address

120 Chesterfield St N
Aiken, SC 29801-3934

Phone

(803) 641-9979

NPI assigned

Jan 10, 2007

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Clinical Psychologist

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Midland Valley Behavioral Health & Consulting, LLC

  • Community/Behavioral Health Agency
  • Graniteville, SC
  • NPI 1770146540
  Medicare reassignment NPD Authorized official
• Season 4 Change, LLC

  • Community/Behavioral Health Agency
  • Graniteville, SC
  • NPI 1578126181
  NPD

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1770632515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 BLAIR DR",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298609785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CHESTERFIELD ST N",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298013934",
            "telephone_number": "803-641-9979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W Hospital Road",
            "address_2": "Eisenhower Army Medical Center",
            "address_purpose": "LOCATION",
            "city": "Ft. Gordon",
            "state": "GA",
            "postal_code": "309055650",
            "country_code": "US",
            "telephone_number": "706-787-2720",
            "fax_number": "706-787-8176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EARLES",
        "first_name": "JAY",
        "middle_name": "E",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "773",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "SC",
            "license": "1469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Oanh Dworzanowski, COTA
• Jordan Dyches, PA-C
• Jason Dyer
• Jennifer P. Eades, MA, CCC-SLP
• Kristen Eagerton, MCD, CCC-SLP
• Chelsa Earley, MSW
• East Aiken Health Center L.L.C.
• East Coast Psychotherapy and Consulting LLC
• Gregory Lawton Eaves, M.D.
• Amaya Edge, FNP

• Health Psychologist in Aiken, SC
• Providers in Aiken, SC by specialty
• Health Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.