Individual provider Active NPI

Jerry L. Sloan, PH.D.

  • Psychologist
  • Wilmington, NC
National Provider Identifier
1801849088
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
340 Issued in NC
Practice address
2311 Canterwood Dr
Wilmington, NC 28401-7300
Phone
(910) 763-2385
Fax
(910) 763-1482
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 340 NC
Psychologist 103T00000X 340 NC Primary

Addresses

Primary practice location

2311 Canterwood Dr
Wilmington, NC 28401-7300

Mailing address

2311 Canterwood Dr
Wilmington, NC 28401-7300
Phone (910) 763-2385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20110215001056 NC Practitioner - Clinical Psychologist 7113107665 Practice locations: Wilmington, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Emory University School of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2311 Canterwood Dr
Wilmington, NC 28401-7300
Phone (910) 763-2385

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
340NCMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1801849088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 CANTERWOOD DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017300",
            "telephone_number": "910-763-2385",
            "fax_number": "910-763-1482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 CANTERWOOD DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017300",
            "telephone_number": "910-763-2385",
            "fax_number": "910-763-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOAN",
        "first_name": "JERRY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "340",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.