Individual provider Active NPI

Sarah (Sally) Avery, PSY.D.

  • Clinical Psychologist
  • Oak Ridge, TN
National Provider Identifier
1255397261
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P0000001375 Issued in TN
Practice address
150 E Division Rd Ste 10
Oak Ridge, TN 37830-6908
Phone
(865) 250-7782
Fax
(865) 482-9488
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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 P0000001375 TN Primary

Addresses

Primary practice location

150 E Division Rd Ste 10
Oak Ridge, TN 37830-6908

Mailing address

150 E Division Rd Ste 10
Oak Ridge, TN 37830-6908
Phone (865) 482-7782

Other identifiers 1

IdentifierTypeStateIssuer
3681866MedicaidTN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061020000335 TN Practitioner - Clinical Psychologist 5890791586 Practice locations: Oak Ridge, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

150 E Division
Suite 10
Oak Ridge, TN 37830-6908
Phone (865) 482-7782

150 E Division Rd
Suite 10
Oak Ridge, TN 37830-6908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1375TNMDBehavioral Analyst
P0000001375TNMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1255397261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E DIVISION RD STE 10",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306908",
            "telephone_number": "865-482-7782",
            "fax_number": "865-482-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E DIVISION RD STE 10",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306908",
            "telephone_number": "865-250-7782",
            "fax_number": "865-482-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "SARAH (SALLY)",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P0000001375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3681866",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.