Individual provider Active NPI

Jody E. Talbott, PH.D.

  • Clinical Psychologist
  • Naples, FL
National Provider Identifier
1861475659
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7020 Issued in FL
Practice address
4521 Executive Dr
204
Naples, FL 34119-9037
Phone
(239) 592-1771
Fax
(239) 592-0258
NPI assigned
Nov 25, 2005
Last updated
May 19, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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 PY7020 FL Primary

Addresses

Primary practice location

4521 Executive Dr
204
Naples, FL 34119-9037

Mailing address

4521 Executive Dr
Suite # 204
Naples, FL 34119-9037
Phone (239) 592-1771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050113001038 FL Practitioner - Clinical Psychologist 8628027992 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

Practice addresses (Care Compare)

4521 Executive Dr
Suite 204
Naples, FL 34119-9034
Phone (239) 592-1771

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychology & Memory Center, P.a. CurrentSince Feb 1, 2007 Accepting new patients

Locations

4521 Executive Dr
Ste 204
Naples, FL 34119
Phone (239) 592-1771

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, 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": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1861475659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4521 EXECUTIVE DR",
            "address_2": "SUITE # 204",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341199037",
            "telephone_number": "239-592-1771",
            "fax_number": "239-592-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4521 EXECUTIVE DR",
            "address_2": "204",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341199037",
            "telephone_number": "239-592-1771",
            "fax_number": "239-592-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALBOTT",
        "first_name": "JODY",
        "middle_name": "E.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-25",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.