NPIMap

Organization Active NPI

Neurobehavioral Associates

  • Clinical Neuropsychologist
  • Johnson City, TN
National Provider Identifier
1174727309
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
103GC0700X Issued in TN
Legal business name
NEUROBEHAVIORAL ASSOCIATES
Practice address
2 Worth Cir Ste 2
Johnson City, TN 37601-4306
Phone
(423) 952-0992
Fax
(423) 952-0284
NPI assigned
Jun 12, 2007
Last updated
May 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Authorized official

Name
Dr. Rodney A Sullivan, PH.D.NPI 1790877561
Title
Owner
Phone
(423) 952-0992

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 103GC0700X TN Primary

Addresses

Primary practice location

2 Worth Cir Ste 2
Johnson City, TN 37601-4306

Mailing address

2 Worth Cir Ste 2
Johnson City, TN 37601-4306
Phone (423) 952-0992

Other identifiers 1

IdentifierTypeStateIssuer
3980369MedicaidTN

National Provider Directory

National Provider Directory

Locations

2 Red Bush Ct
Ste 2
Johnson City, TN 37601
Phone (423) 283-4958

2 Worth Cir
Ste 2
Johnson City, TN 37601
Phone (423) 283-4958

214 E Mountcastle Dr
Ste 1
Johnson City, TN 37601
Phone (423) 283-4958

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1174727309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WORTH CIR STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014306",
            "telephone_number": "423-952-0992",
            "fax_number": "423-952-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WORTH CIR STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014306",
            "telephone_number": "423-952-0992",
            "fax_number": "423-952-0284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROBEHAVIORAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-952-0992",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TN",
            "license": "103GC0700X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3980369",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.