Active NPI
Meredith K Ginley, PH.D.
- Clinical Psychologist
- Johnson City, TN
National Provider Identifier
1245856566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3598
- Practice address
- 166 Derosier Dr
Johnson City, TN 37614-5200 - Phone
- (423) 439-7777
- Fax
- (423) 439-7780
- NPI assigned
- Jun 23, 2020
- Last updated
- Jun 23, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 3598 | TN | Primary |
Addresses
Primary practice location
166 Derosier Dr
Johnson City, TN 37614-5200
Mailing address
PO Box 70416
Etsu Department of Psychology
Johnson City, TN 37614
Phone (423) 439-4113
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3598 | TN | MD | Neurology Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592870400000",
"number": "1245856566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 70416",
"address_2": "ETSU DEPARTMENT OF PSYCHOLOGY",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "37614",
"telephone_number": "423-439-4113"
},
{
"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",
"fax_number": "423-439-7780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GINLEY",
"first_name": "MEREDITH",
"middle_name": "K",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-23",
"last_updated": "2020-06-23",
"certification_date": "2020-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "3598",
"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 Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.