Individual provider Active NPI

Ann Graham Parker, PHD

  • Psychologist
  • Chattanooga, TN
National Provider Identifier
1164838058
Registry record updated Jul 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
P0000002185 Issued in TN
Practice address
615 Derby St
Chattanooga, TN 37404-1632
Phone
(423) 493-2916
Fax
(423) 493-2950
NPI assigned
Jul 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2014

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X P0000002185 TN Primary
Cognitive & Behavioral Psychologist 103TB0200X
Family Psychologist 103TF0000X
Health Psychologist 103TH0004X
Intellectual & Developmental Disabilities Psychologist 103TM1800X
School Psychologist 103TS0200X

Addresses

Primary practice location

615 Derby St
Chattanooga, TN 37404-1632

Mailing address

615 Derby St
Chattanooga, TN 37404-1632
Phone (423) 493-2916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150831002436 TN Practitioner - Clinical Psychologist 9638314578 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NV Pacs 2 LLCGroup PAC ID 0941550578, 119 clinicians

Practice addresses (Care Compare)

3530 Keith St NW
Cleveland, TN 37312-4309
Phone (423) 476-3254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
P0000002185TNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Pac Healthcare Services of Tennessee PC Psychologist CurrentSince Nov 16, 2019 Accepting new patients
NV Pacs 2 LLC CurrentSince Aug 1, 2021 Accepting new patients
CS Pacs 3 Southeast, LLC CurrentSince Sep 14, 2024 Accepting new patients

Locations

615 Derby St
Chattanooga, TN 37404
Phone (423) 493-2905

3530 Keith St NW
Cleveland, TN 37312
Phone (423) 309-7567

880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669

40 Nursing Home Rd
Lynchburg, TN 37352
Phone (931) 359-6000

395 Interstate Dr
Manchester, TN 37355
Phone (931) 723-8744

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1164838058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 DERBY ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041632",
            "telephone_number": "423-493-2916",
            "fax_number": "423-493-2950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 DERBY ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041632",
            "telephone_number": "423-493-2916",
            "fax_number": "423-493-2950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "ANN",
        "middle_name": "GRAHAM",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-11",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "P0000002185",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.