Individual provider Active NPI

Sandra Jacomet

  • School Psychologist
  • Trotwood, OH
National Provider Identifier
1770982860
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
OK1000942 Issued in OK
Practice address
4400 N Union Rd
Trotwood, OH 45426-3706
Phone
(937) 854-4511
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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 OK1000942 OK Primary

Addresses

Primary practice location

4400 N Union Rd
Trotwood, OH 45426-3706

Mailing address

4400 N Union Rd
Trotwood, OH 45426-3706
Phone (937) 854-4511

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
OK1000942OKMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1770982860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 N UNION RD",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454263706",
            "telephone_number": "937-854-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 N UNION RD",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454263706",
            "telephone_number": "937-854-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOMET",
        "first_name": "SANDRA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OK",
            "license": "OK1000942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trotwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.