Active NPI
Jerry Melcher, CLINICAL PSYCHOLOGIS
- Clinical Psychologist
- Jackson, TN
National Provider Identifier
1013118934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1229
- Practice address
- 50 Bent Creek LN
Jackson, TN 38305-2170 - Phone
- (731) 661-9109
- Fax
- (731) 661-9110
- NPI assigned
- May 29, 2007
- Last updated
- Jul 29, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1229 | TN | Primary |
Addresses
Primary practice location
50 Bent Creek LN
Jackson, TN 38305-2170
Mailing address
1804 Highway 45 Byp
Suite 604
Jackson, TN 38305-4436
Phone (731) 660-8759
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 |
|---|---|---|---|
| 1229 | TN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William R. Gentry, Jr., PH.D., P.C. | Clinical | Past | Accepting new patients |
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.
-
- Clinical Psychologist
- Germantown, TN
- NPI 1669675898
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248825600000",
"number": "1013118934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1804 HIGHWAY 45 BYP",
"address_2": "SUITE 604",
"city": "JACKSON",
"state": "TN",
"postal_code": "383054436",
"telephone_number": "731-660-8759"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 BENT CREEK LN",
"city": "JACKSON",
"state": "TN",
"postal_code": "383052170",
"telephone_number": "731-661-9109",
"fax_number": "731-661-9110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELCHER",
"first_name": "JERRY",
"credential": "CLINICAL PSYCHOLOGIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-29",
"last_updated": "2009-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "1229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.