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Active NPI 1912908963 Individual Practitioner Male Practitioner

Dr. Jerrell Lee Driver , PhD

Psychologist - Clinical • Jackson, MO

Professional Overview & Biography Verified Profile Summary

Dr. Jerrell Driver, PhD is a registered healthcare professional specializing in Psychologist - Clinical in Jackson, MO. Practice services are available at 2387 W JACKSON BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2387 W Jackson Blvd
Suite B

Jackson, MO 637553024

Telephone 5732047771
Fax 5732047771
Associated Practice Facility / Clinic
🏢 Jackson Medical Center Pc Facility NPI 1508048125

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Clinical in Jackson, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 20.2 Yrs
Regional Practice Density
2 Specialists

Practicing in Jackson, MO (963 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist - Clinical Primary Specialty

NUCC Taxonomy Code: 103TC0700X

State License MO PY 00099

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
493204309 (MO)
Commercial Insurance / Payer ID Mo-License Psychologist
PY00099

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Dr. Geoffrey Enders , DPT

Physical Therapist

NPI 1053650259

Doctor of Physical Therapy

Justin Franke

Physical Therapist

NPI 1134389950
Dr. Julia Pewitt , DO

Family Medicine

NPI 1346487931

Doctor of Osteopathic Medicine (D.O.)

NPI 1740389980

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active September 10, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location September 10, 2011

Registered at 2387 W JACKSON BLVD, SUITE B, JACKSON, MO 637553024 (Tel: 5732047771)

📍
Updated Business Mailing Address September 10, 2011

Registered at POST OFFICE BOX 1642, CAPE GIRARDEAU, MO 637021642 (Tel: 5732047771)

👤
Provider Name / Credentials Updated September 10, 2011

Recorded as JERRELL DRIVER, PHD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 10, 2011

Psychologist (License #PY 00099 in MO)

🟢
Initial NPI Registration & Enumeration August 02, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1912908963
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 02, 2005
Last Update: September 10, 2011
Sole Proprietor: Yes

Mailing Address

Post Office Box 1642

Cape Girardeau, MO 637021642

Phone: 5732047771

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.