Individual provider Active NPI

Dawn Kristine Fox, PSYD

  • Clinical Psychologist
  • Orange Park, FL
National Provider Identifier
1982670774
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 7122 Issued in FL
Practice address
358 Stiles Ave
Suite B
Orange Park, FL 32073-4012
Phone
(904) 264-8311
Fax
(904) 264-8377
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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 PY 7122 FL Primary

Addresses

Primary practice location

358 Stiles Ave
Suite B
Orange Park, FL 32073-4012

Mailing address

358 Stiles Ave
Suite B
Orange Park, FL 32073-4012
Phone (904) 264-8311

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
I20060607000199 FL Practitioner - Clinical Psychologist 2062424161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological Services of Jacksonville LLCGroup PAC ID 4880606987, 3 clinicians

Practice addresses (Care Compare)

358 Stiles Ave
Suite B
Orange Park, FL 32073-4012
Phone (904) 264-8311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY 7122FLMDClinical Psychologist

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1982670774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 STILES AVE",
            "address_2": "SUITE B",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734012",
            "telephone_number": "904-264-8311",
            "fax_number": "904-264-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 STILES AVE",
            "address_2": "SUITE B",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734012",
            "telephone_number": "904-264-8311",
            "fax_number": "904-264-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "DAWN",
        "middle_name": "KRISTINE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 7122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.