Jon R. Webb, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P2762 Issued in TN

Practice address

807 University Pkwy
139 Lucille Clement Hall
Johnson City, TN 37614-6500

Phone

(423) 439-7777

Fax

(423) 439-7780

NPI assigned

Jul 18, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Etsu Behavioral Health and Wellness Clinic

  • Community/Behavioral Health Agency
  • Johnson City, TN
  • NPI 1073872776
  NPD (past)

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1194070946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 UNIVERSITY PKWY",
            "address_2": "BOX 70649, ETSU",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376146500",
            "telephone_number": "423-439-4466",
            "fax_number": "423-439-5695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 UNIVERSITY PKWY",
            "address_2": "139 LUCILLE CLEMENT HALL",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376146500",
            "telephone_number": "423-439-7777",
            "fax_number": "423-439-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBB",
        "first_name": "JON",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P2762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian K Way, D.O.
• Lynda G Weatherly, FNP
• Elizabeth June Weaver, APRN
• Isaac Matthew Shepard Weaver, RN
• Clinton Steve Webb, MD
• Laurie Lea Webb, LCSW
• William Webb
• Kenzly Weddle
• Christy Isbell Weems, PH.D. OTR/L
• Lisa M Weems, LPN

• Clinical Psychologist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; 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.