Active NPI
Joanne Jackson
- Psychologist
- Croton on Hudson, NY
National Provider Identifier
1871711291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 8206-1
- Practice address
- 104 Grand St
Croton on Hudson, NY 10520-2305 - Phone
- (914) 271-4415
- Fax
- (914) 271-4415
- NPI assigned
- Apr 23, 2007
- 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 | 8206-1 | NY | Primary |
Addresses
Primary practice location
104 Grand St
Croton on Hudson, NY 10520-2305
Mailing address
341 Furnace Dock Rd
Condo 1, Ajpt. 7
Cortlandt Manor, NY 10567-6534
Phone (914) 736-2235
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040211000398 | NY | Practitioner - Clinical Psychologist | 6103710132 | Practice locations: Croton on Hudson, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1392 Albany Post Rd
Suite 2a
Croton on Hudson, NY 10520-1560
Phone (914) 271-4415
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8206-1 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871711291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "341 FURNACE DOCK RD",
"address_2": "CONDO 1, AJPT. 7",
"city": "CORTLANDT MANOR",
"state": "NY",
"postal_code": "105676534",
"telephone_number": "914-736-2235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 GRAND ST",
"city": "CROTON ON HUDSON",
"state": "NY",
"postal_code": "105202305",
"telephone_number": "914-271-4415",
"fax_number": "914-271-4415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JOANNE",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "8206-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Croton on Hudson, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.