Active NPI
Dudley B Pillow III, PSY.D.
- Clinical Psychologist
- Germantown, TN
National Provider Identifier
1194925529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P2324
- Practice address
- 2176 West St
Suite 200a
Germantown, TN 38138-3869 - Phone
- (901) 756-5730
- NPI assigned
- Jul 24, 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 Psychologist | 103TC0700X | P2324 | TN | Primary |
Addresses
Primary practice location
2176 West St
Suite 200a
Germantown, TN 38138-3869
Mailing address
2176 West St
Suite 200a
Germantown, TN 38138-3869
Phone (901) 756-5730
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P2324 | TN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185235200000",
"number": "1194925529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2176 WEST ST",
"address_2": "SUITE 200A",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381383869",
"telephone_number": "901-756-5730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2176 WEST ST",
"address_2": "SUITE 200A",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381383869",
"telephone_number": "901-756-5730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PILLOW",
"first_name": "DUDLEY",
"middle_name": "B",
"name_suffix": "III",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-24",
"last_updated": "2007-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "P2324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Germantown, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.