Individual provider Active NPI

Robert William Adams, PHD MBA

  • Psychologist
  • Memphis, TN
National Provider Identifier
1194390567
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3673 Issued in TN
Practice address
1661 International Place Dr Ste 400
Memphis, TN 38120-1431
Phone
(901) 767-7771
Fax
(901) 767-4441
NPI assigned
May 26, 2021
Last updated
Jun 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3673 TN Primary

Addresses

Primary practice location

1661 International Place Dr Ste 400
Memphis, TN 38120-1431

Mailing address

505 Primrose CV
Memphis, TN 38117-3645
Phone (901) 482-0155

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
Master of Business Administration, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3673TNMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1194390567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PRIMROSE CV",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381173645",
            "telephone_number": "901-482-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 INTERNATIONAL PLACE DR STE 400",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381201431",
            "telephone_number": "901-767-7771",
            "fax_number": "901-767-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "ROBERT",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PHD MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "3673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.