JAMES NOVEMBER PHD PA
NPI 1104193119
Psychologist - Clinical in Jacksonville, FL
About James November Phd Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JAMES NOVEMBER PHD PA (NPI 1104193119) is a healthcare organization registered as a clinical in Jacksonville, Florida and active in the NPI registry since November 2011. The organization lists James November, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
James November Phd Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to James November Phd PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
Ponte Vedra Beach, FL 32082
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is James November Phd PA's NPI number?
The NPI number for James November Phd PA is 1104193119. It was assigned to this organization in the NPPES registry on November 18, 2011.
Where is James November Phd PA located?
James November Phd PA is located at 943 Cesery Blvd, Jacksonville, FL 32211. The listed phone number is (904) 745-3111.
What is James November Phd PA's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is James November Phd PA enrolled in Medicare?
Yes. James November Phd PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through James November Phd PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to James November Phd PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for James November Phd PA was last updated on November 18, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# James November Phd Pa · NPI 1104193119
Clinical organization in Jacksonville, Florida. Organization record, active in the CMS NPPES registry since November 18, 2011.
## Identity
- **NPI:** 1104193119 (Entity type: Organization)
- **Enumerated:** November 18, 2011
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **Organization subpart:** No
- **Authorized official:** James November, OWNER
## Practice location
- **Address:** 943 CESERY BLVD, Jacksonville, FL 32211-5635
- **Phone:** (904) 745-3111
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Clinical Psychologist) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 18, 2011
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Source: [NPI Profile](https://npiprofile.com/npi/1104193119) · Data from the CMS NPPES public registry.