Individual provider Active NPI

Jay Michael Stone, PH.D.

  • Clinical Psychologist
  • Gulfport, MS
National Provider Identifier
1801876545
Registry record updated Jul 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
53935 Issued in MS
Practice address
8990 Lorraine Rd
Gulfport, MS 39503-4176
Phone
(228) 331-3310
Fax
(228) 284-1608
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2016

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 0810002934 VA
Clinical Psychologist 103TC0700X 53935 MS Primary

Addresses

Primary practice location

8990 Lorraine Rd
Gulfport, MS 39503-4176

Mailing address

8990 Lorraine Rd
Gulfport, MS 39503-4176
Phone (228) 331-3310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160120000423 MS Practitioner - Psychologist Billing Independently 6800199167 Practice locations: Gulfport, MS
I20160728000222 MS Practitioner - Clinical Psychologist 6800199167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8990 Lorraine Rd
Gulfport, MS 39503-4176
Phone (228) 331-3310

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0810002934VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
River Psychology PLLC Clinical CurrentSince Mar 26, 2016 Accepting new patients

Locations

8990 Lorraine Rd
Gulfport, MS 39503
Phone (228) 331-3310

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467676800000",
    "number": "1801876545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8990 LORRAINE RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034176",
            "telephone_number": "228-331-3310",
            "fax_number": "228-284-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8990 LORRAINE RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034176",
            "telephone_number": "228-331-3310",
            "fax_number": "228-284-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONE",
        "first_name": "JAY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2016-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002934",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MS",
            "license": "53935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.