Active NPI
Lisa Paderna, PH.D.
- Clinical Psychologist
- Mountain Home, TN
National Provider Identifier
1154610723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P2875
- Practice address
- James H. Quillen Vamc
116B
Mountain Home, TN 37684 - Phone
- (423) 926-1171
- NPI assigned
- Apr 4, 2011
- Sex
- Female
- 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 | P2875 | TN | Primary |
Addresses
Primary practice location
James H. Quillen Vamc
116B
Mountain Home, TN 37684
Mailing address
PO Box 4000, 116B
James H. Quillen Vamc
Mountain Home, TN 37684
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P2875 | TN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301875200000",
"number": "1154610723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4000, 116B",
"address_2": "JAMES H. QUILLEN VAMC",
"city": "MOUNTAIN HOME",
"state": "TN",
"postal_code": "37684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "JAMES H. QUILLEN VAMC",
"address_2": "116B",
"city": "MOUNTAIN HOME",
"state": "TN",
"postal_code": "37684",
"telephone_number": "423-926-1171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PADERNA",
"first_name": "LISA",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-04",
"last_updated": "2011-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "P2875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.