Active NPI
Eric S. Engum, PH.D., J.D.
- Clinical Neuropsychologist
- Knoxville, TN
National Provider Identifier
1174738512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- P0000000908
- Practice address
- Cross Park Plaza, Suite D266
9111 Cross Park Drive
Knoxville, TN 37923-4506 - Phone
- (865) 531-0560
- Fax
- (865) 531-2846
- NPI assigned
- May 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 Neuropsychologist | 103G00000X | P0000000908 | TN | Primary |
Addresses
Primary practice location
Cross Park Plaza, Suite D266
9111 Cross Park Drive
Knoxville, TN 37923-4506
Mailing address
Cross Park Plaza, Suite D266
9111 Cross Park Drive
Knoxville, TN 37923-4506
Phone (865) 531-0560
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
- Juris Doctor, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P0000000908 | TN | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174738512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "CROSS PARK PLAZA, SUITE D266",
"address_2": "9111 CROSS PARK DRIVE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379234506",
"telephone_number": "865-531-0560",
"fax_number": "865-531-2846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CROSS PARK PLAZA, SUITE D266",
"address_2": "9111 CROSS PARK DRIVE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379234506",
"telephone_number": "865-531-0560",
"fax_number": "865-531-2846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGUM",
"first_name": "ERIC",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "PH.D., J.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "TN",
"license": "P0000000908",
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.