Jill Anita Folsom, PMHNP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F40308201 Issued in NY

Practice address

8 Broad St
Plattsburgh, NY 12901-3420

Phone

(518) 825-1555

Fax

(518) 825-1550

NPI assigned

Jul 27, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

State University of New York at Stony Brook, School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Country Behavioral Medicine PLLCGroup PAC ID 2668744756, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• North Country Behavioral Medicine PLLC

  • Psychiatry Physician
  • Plattsburgh, NY
  • NPI 1881121234
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1861001836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 SMART RD",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129017647",
            "telephone_number": "518-569-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 BROAD ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129013420",
            "telephone_number": "518-825-1555",
            "fax_number": "518-825-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLSOM",
        "first_name": "JILL",
        "middle_name": "ANITA",
        "name_prefix": "Ms.",
        "credential": "PMHNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-27",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F40308201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Plattsburgh",
            "affiliation": "N",
            "address_1": "8 Broad St",
            "city": "Plattsburgh",
            "state": "NY",
            "country_code": "US",
            "postal_code": "129013420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jocelyn Marie Fittin, RN IBCLC
• Alexander William Fleming, LMSW
• Rachel Flemming, M.A., CCC-SLP
• Dakota Flynn, LMHC
• Timothy E Foley, P.A.
• Emily Foppert
• Aubrey Lauren Ford, NP
• Brion Forget, R.PH.
• Rebekah Fortin Lawrence, MSED
• Jean-Luc Fortin

• Psychiatric/Mental Health Nurse Practitioner in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.