Active NPI
Todd Douglas Eaton, PH.D.
- Clinical Psychologist
- Chattanooga, TN
National Provider Identifier
1043315609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P2021
- Practice address
- 6110 Shallowford Rd
C O CRC
Chattanooga, TN 37421-1894 - Phone
- (800) 632-6074
- Fax
- (866) 341-7509
- NPI assigned
- Sep 14, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3016 | NC | |
| Clinical Psychologist | 103TC0700X | P2021 | TN | Primary |
Addresses
Primary practice location
6110 Shallowford Rd
C O CRC
Chattanooga, TN 37421-1894
Mailing address
PO Box 10414
Largo, FL 33773-0414
Phone (800) 632-6074
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1345623 | Other | TN | BCBS |
| 6000839 | Medicaid | NC |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3016 | NC | MD | Clinical Psychologist |
| P2021 | TN | MD | Clinical Psychologist |
| 2021 | TN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paradigm Health Services, Inc | Past | Accepting new patients | |
| Paradigm Health, LLC | Clinical | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Clearwater, FL
- NPI 1578519146
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202860800000",
"number": "1043315609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10414",
"city": "LARGO",
"state": "FL",
"postal_code": "337730414",
"telephone_number": "800-632-6074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6110 SHALLOWFORD RD",
"address_2": "C O CRC",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374211894",
"telephone_number": "800-632-6074",
"fax_number": "866-341-7509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EATON",
"first_name": "TODD",
"middle_name": "DOUGLAS",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2008-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "3016",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "P2021",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1345623",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6000839",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.