Individual provider Active NPI

Jessica N. Cain

  • Specialist
  • Georgetown, TX
National Provider Identifier
1780199976
Registry record updated Oct 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
14525 Issued in TX
Practice address
4747 Williams Dr Ste 334
Georgetown, TX 78633-2017
Phone
(512) 826-2527
NPI assigned
Dec 10, 2017
Last updated
Oct 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 14525 TX Primary

Addresses

Primary practice location

4747 Williams Dr Ste 334
Georgetown, TX 78633-2017

Mailing address

4747 Williams Dr Ste 334
Georgetown, TX 78633-2017
Phone (512) 826-2527

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
14525TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Imyo: Orofacial Myology of Central Texas Dental Hygienist Current Accepting new patients

Locations

1 Chisholm Trail Rd
Ste 450
Round Rock, TX 78681
Phone (318) 451-2137

Organizations & group practices 1

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": "1512864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635638400000",
    "number": "1780199976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 WILLIAMS DR STE 334",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786332017",
            "telephone_number": "512-826-2527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 WILLIAMS DR STE 334",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786332017",
            "telephone_number": "512-826-2527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "JESSICA",
        "middle_name": "N.",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-10",
        "last_updated": "2021-10-31",
        "certification_date": "2021-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "14525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2021; 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.