Individual provider Active NPI

Julia Dodd, PHD

  • Clinical Psychologist
  • Johnson City, TN
National Provider Identifier
1235780131
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3449 Issued in TN
Practice address
166 Derosier Dr
Johnson City, TN 37614-5200
Phone
(423) 439-7777
NPI assigned
Sep 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3449 TN Primary

Addresses

Primary practice location

166 Derosier Dr
Johnson City, TN 37614-5200

Mailing address

309 Stout Dr.
420 Roger Stout Hall
Johnson City, TN 37614
Phone (423) 439-4847

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3449TNMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1235780131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 STOUT DR.",
            "address_2": "420 ROGER STOUT HALL",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37614",
            "telephone_number": "423-439-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 DEROSIER DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376145200",
            "telephone_number": "423-439-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODD",
        "first_name": "JULIA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "3449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.