Guy M Edlis, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2873 Issued in TN

Practice address

305 Westfield Dr
Knoxville, TN 37919-4824

Phone

(865) 584-8547

NPI assigned

Jun 16, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Williams Psychological Corp

  • Clinical Psychologist
  • Knoxville, TN
  • NPI 1710965728
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252886400000",
    "number": "1043415466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 WESTFIELD DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194824",
            "telephone_number": "865-584-8547",
            "fax_number": "865-584-5932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 WESTFIELD DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194824",
            "telephone_number": "865-584-8547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDLIS",
        "first_name": "GUY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-16",
        "last_updated": "2009-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "2873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Leslie Edge, M.D.
• Heather Edgley, M.D.
• Chevy Edington, M.ED, BCBA
• Lara Lee Edington, M.A.
• Brian S Edkin, M.D.
• Devon Edmisten, B.S.S.W
• Megan K Edmisten, NP-C
• Paul Caleb Edmiston, DC
• Katherine Hogan Edmonds, CRNA
• Tyler Edmondson

• Clinical Psychologist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.

Verify at the official NPI Registry.