NPIMap

Organization Active NPI

L. Michael Sherrod, PH.D, , P.C.

  • Clinical Psychologist
  • Knoxville, TN
National Provider Identifier
1205919651
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
532 Issued in TN
Legal business name
L. MICHAEL SHERROD, PH.D, , P.C.
Practice address
9217 Park West Blvd
Suite D1
Knoxville, TN 37923-4404
Phone
(865) 691-2425
Fax
(865) 531-8440
NPI assigned
Oct 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. L. Michael Sherrod, PH.D.
Title
President
Phone
(865) 691-2425

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 532 TN Primary

Addresses

Primary practice location

9217 Park West Blvd
Suite D1
Knoxville, TN 37923-4404

Mailing address

9217 Park West Blvd
Suite D1
Knoxville, TN 37923-4404
Phone (865) 691-2425

Other identifiers 7

IdentifierTypeStateIssuer
0014156OtherTNBCBSTN
5226618OtherTNAETNA
9455777OtherTNPHCS
23871OtherTNCIGNABEHAVIORALHEALTH
3683167MedicaidTN
932OtherTNPRIME PROVIDER SYSTEMS
257987OtherTNCOMPSYCH

National Provider Directory

National Provider Directory

Locations

9217 Park West Blvd
Ste D1
Knoxville, TN 37923
Phone (865) 212-9255

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1161388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1205919651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9217 PARK WEST BLVD",
            "address_2": "SUITE D1",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234404",
            "telephone_number": "865-691-2425",
            "fax_number": "865-531-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9217 PARK WEST BLVD",
            "address_2": "SUITE D1",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234404",
            "telephone_number": "865-691-2425",
            "fax_number": "865-531-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L. MICHAEL SHERROD, PH.D, , P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-21",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SHERROD",
        "authorized_official_first_name": "L.",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-691-2425",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTN",
            "identifier": "0014156",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5226618",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "9455777",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNABEHAVIORALHEALTH",
            "identifier": "23871",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3683167",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIME PROVIDER SYSTEMS",
            "identifier": "932",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "257987",
            "state": "TN"
        }
    ],
    "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 Apr 20, 2008; 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.