Individual provider Active NPI

Jeffrey Allan Rommel, PSYD

  • Clinical Psychologist
  • Jacksonville, FL
National Provider Identifier
1801236542
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY8496 Issued in FL
Practice address
11150 Castlemain Cir S
Jacksonville, FL 32256-4825
Phone
(727) 798-1876
NPI assigned
Jun 26, 2013
Last updated
Jun 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY8496 FL Primary

Addresses

Primary practice location

11150 Castlemain Cir S
Jacksonville, FL 32256-4825

Mailing address

11150 Castlemain Cir S
Jacksonville, FL 32256-4825

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
PY8496FLMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1801236542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11150 CASTLEMAIN CIR S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11150 CASTLEMAIN CIR S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564825",
            "telephone_number": "727-798-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMMEL",
        "first_name": "JEFFREY",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; 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.