Individual provider Active NPI

Jarrod Lynn Justice, MAMFT

  • Marriage & Family Therapist
  • Knoxville, TN
National Provider Identifier
1174180111
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1674 Issued in TN
Practice address
110 Perimeter Park Rd Ste a
Knoxville, TN 37922-2200
Phone
(865) 409-5001
Fax
(865) 415-3311
NPI assigned
May 24, 2019
Last updated
Jan 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1674 TN Primary
Marriage & Family Therapist 106H00000X NU

Addresses

Primary practice location

110 Perimeter Park Rd Ste a
Knoxville, TN 37922-2200

Mailing address

110 Perimeter Park Rd Ste a
Knoxville, TN 37922-2200
Phone (865) 409-5001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 9, 2024 through May 9, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1674TNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Negev Institute Marriage & Family Therapist CurrentSince Jan 19, 2025 Accepting new patients

Locations

110 Perimeter Park Rd
Ste A
Knoxville, TN 37922
Phone (865) 288-8970

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1174180111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PERIMETER PARK RD STE A",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379222200",
            "telephone_number": "865-409-5001",
            "fax_number": "865-415-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PERIMETER PARK RD STE A",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379222200",
            "telephone_number": "865-409-5001",
            "fax_number": "865-415-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "JARROD",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "credential": "MAMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-24",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TN",
            "license": "1674",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.