Organization Active NPI

Martha Wike, PH.D., P.C.

  • Clinical Psychologist
  • Knoxville, TN
National Provider Identifier
1083059166
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1710 Issued in TN
Legal business name
MARTHA WIKE, PH.D., P.C.
Practice address
4006 Sutherland Ave
Knoxville, TN 37919-5103
Phone
(865) 584-6111
NPI assigned
May 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Authorized official

Name
Dr. Martha Wike, PH.D.
Title
President
Phone
(865) 584-6111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 1710 TN Primary

Addresses

Primary practice location

4006 Sutherland Ave
Knoxville, TN 37919-5103

Mailing address

PO Box 11423
Knoxville, TN 37939-1423
Phone (865) 584-6111

Other identifiers 1

IdentifierTypeStateIssuer
1518034MedicaidTN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1083059166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11423",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379391423",
            "telephone_number": "865-584-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4006 SUTHERLAND AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195103",
            "telephone_number": "865-584-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA WIKE, PH.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-02",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "WIKE",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-584-6111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "1710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518034",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; 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.