Jeffrey R. Campodonico, PH.D., P.a.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

3071 Issued in MD

Legal business name

JEFFREY R. CAMPODONICO, PH.D., P.A.

Doing business as

NeuroHealth Consulting

Practice address

120 Sister Pierre Dr
Suite 501
Towson, MD 21204-7516

Phone

(410) 337-6801

Fax

(410) 337-8686

NPI assigned

Mar 13, 2008

Last updated

Mar 13, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Rudolph Campodonico, PH.D.NPI 1407908395

Title

President/Ceo

Phone

(410) 337-6801

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• NeuroHealth Consulting Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey Campodonico, PH.D.

  • Clinical Neuropsychologist
  • Towson, MD
  • NPI 1407908395
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1790956118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 PICCADILLY RD",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212043716",
            "telephone_number": "410-598-4966",
            "fax_number": "410-337-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SISTER PIERRE DR",
            "address_2": "SUITE 501",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047516",
            "telephone_number": "410-337-6801",
            "fax_number": "410-337-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY R. CAMPODONICO, PH.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "CAMPODONICO",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "RUDOLPH",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "410-337-6801",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MD",
            "license": "3071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUE SHIELD",
            "identifier": "KEJ2",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NeuroHealth Consulting",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeanie Neuman Therapy & Wellness
• Jecc Health Associates, LLC
• Jecc Health Associates, LLC
• Hannah Kimberly Jefferson, L.AC
• Kamyah Jefferson
• Jeffrey S Alexander MD PA
• Di'En Jenkins
• Diamond Jenkins
• Dominick Jenkins
• Kisha Jenkins, PHD

• Clinical Neuropsychologist in Towson, MD
• Providers in Towson, MD by specialty
• Clinical Neuropsychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.