Integrative Medicine Specialists LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P1235 Issued in TN

Legal business name

INTEGRATIVE MEDICINE SPECIALISTS LLC

Practice address

9333 Park West Blvd
Knoxville, TN 37923-4341

Phone

(865) 235-1254

NPI assigned

Aug 26, 2014

Organization subpart

No

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

Authorized official

Name

Dr. C Keith Hulse, PH.D.

Title

Member

Phone

(865) 264-2400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409011200000",
    "number": "1174923296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 WESTFIELD RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9333 PARK WEST BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234341",
            "telephone_number": "865-235-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE MEDICINE SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-26",
        "last_updated": "2014-08-26",
        "status": "A",
        "authorized_official_last_name": "HULSE",
        "authorized_official_first_name": "C KEITH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "865-264-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P1235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; 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.