Active NPI
Jill N/a Poorman, PSY.D.
- Psychologist
- Pinellas Park, FL
National Provider Identifier
1861632952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4680
- Practice address
- 5046 73Rd Ave
Pinellas Park, FL 33781-4350 - Phone
- (727) 541-5436
- Fax
- (727) 541-5484
- NPI assigned
- Mar 2, 2009
- Last updated
- Mar 2, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4680 | FL | Primary |
Addresses
Primary practice location
5046 73Rd Ave
Pinellas Park, FL 33781-4350
Mailing address
5046 73Rd Ave
Pinellas Park, FL 33781-4350
Phone (727) 541-5436
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4680 | FL | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235952000000",
"number": "1861632952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5046 73RD AVE",
"city": "PINELLAS PARK",
"state": "FL",
"postal_code": "337814350",
"telephone_number": "727-541-5436",
"fax_number": "727-541-5484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5046 73RD AVE",
"city": "PINELLAS PARK",
"state": "FL",
"postal_code": "337814350",
"telephone_number": "727-541-5436",
"fax_number": "727-541-5484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POORMAN",
"first_name": "JILL",
"middle_name": "N/A",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-02",
"last_updated": "2009-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "4680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pinellas Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.