Roy John Kersey, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

P501 Issued in TN

Practice address

3105 Essary Dr
Knoxville, TN 37918-2409

Phone

(865) 687-8990

Fax

(865) 687-1190

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Alternative Counseling Center

  • Community/Behavioral Health Agency
  • Knoxville, TN
  • NPI 1376715482
  NPD (past)
• Helen Ross McNabb Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Knoxville, TN
  • NPI 1659330686
  NPD (past)

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245256254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 ESSARY DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379182409",
            "telephone_number": "865-687-8990",
            "fax_number": "865-687-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 ESSARY DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379182409",
            "telephone_number": "865-687-8990",
            "fax_number": "865-687-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSEY",
        "first_name": "ROY",
        "middle_name": "JOHN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "P501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3684570",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4033879",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Douglas Kerr, M.D.
• Travis Kerr
• James Richard Kerrigan, M.D.
• Kersey Family Care, PC
• Laura G Kersey, OT/ PT
• Savannah Kerstetter, MS, CF-SLP
• Inara Gadzhiyeva Kestner
• Caitlin Ketelsen
• Amelia Leigh Anne Ketring, APRN
• Gillian Kay Ketron

• Psychologist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.