Individual provider Active NPI

Jessica Brooke Virzi, PSY.D.

  • Clinical Psychologist
  • Ames, IA
National Provider Identifier
1831547439
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
081009 Issued in IA
Practice address
3401 Cullen Dr
Ames, IA 50010-1164
Phone
(440) 570-6910
NPI assigned
May 25, 2016
Last updated
May 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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 081009 IA Primary

Addresses

Primary practice location

3401 Cullen Dr
Ames, IA 50010-1164

Mailing address

3401 Cullen Dr
Ames, IA 50010-1164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20160816001156 IA Practitioner - Clinical Psychologist 6507150471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Wright State University Boonshoft School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Capstone Behavioral Healthcare IncGroup PAC ID 0648169573, 13 clinicians

Practice addresses (Care Compare)

200 4TH Ave W
Grinnell, IA 50112-1833
Phone (641) 528-6065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
081009IAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Capstone Behavioral Healthcare, Inc CurrentSince Jun 28, 2016 Accepting new patients
Poweshiek County Mental Health Center Past Accepting new patients

Locations

200 4th Ave W
Grinnell, IA 50112
Phone (641) 236-6137

1123 1st Ave E
Ste 200
Newton, IA 50208
Phone (641) 792-4012

Organizations & group practices 2

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": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1831547439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CULLEN DR",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500101164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CULLEN DR",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500101164",
            "telephone_number": "440-570-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRZI",
        "first_name": "JESSICA",
        "middle_name": "BROOKE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-25",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "081009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

Verify at the official NPI Registry.