Active NPI
Richard Jeffrey Munson, PHD
- Clinical Neuropsychologist
- Jefferson City, TN
National Provider Identifier
1245314681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- P00001896
- Practice address
- 104 B West Old Aj Hwy
Jefferson City, TN 37760-0287 - Phone
- (865) 471-1460
- Fax
- (865) 471-1460
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | P00001896 | TN | |
| Clinical Neuropsychologist | 103G00000X | P00001896 | TN | Primary |
Addresses
Primary practice location
104 B West Old Aj Hwy
Jefferson City, TN 37760-0287
Mailing address
PO Box 287
104 B West Old Andrew Johnson Highway
Jefferson City, TN 37760-0287
Phone (865) 471-1460
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120522000704 | TN | Practitioner - Clinical Psychologist | 1658534193 | Practice locations: Jefferson City, TN |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P00001896 | TN | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361491200000",
"number": "1245314681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 287",
"address_2": "104 B WEST OLD ANDREW JOHNSON HIGHWAY",
"city": "JEFFERSON CITY",
"state": "TN",
"postal_code": "377600287",
"telephone_number": "865-471-1460",
"fax_number": "865-471-1460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 B WEST OLD AJ HWY",
"city": "JEFFERSON CITY",
"state": "TN",
"postal_code": "377600287",
"telephone_number": "865-471-1460",
"fax_number": "865-471-1460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNSON",
"first_name": "RICHARD",
"middle_name": "JEFFREY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2013-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "P00001896",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "TN",
"license": "P00001896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jefferson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.