Active NPI
Michael Sanders
- Clinical Psychologist
- Knoxville, TN
National Provider Identifier
1265991673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P1043
- Practice address
- 100 Forest CT
Knoxville, TN 37919-5079 - Phone
- (865) 673-8888
- NPI assigned
- Mar 15, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | P1043 | TN | Primary |
Addresses
Primary practice location
100 Forest CT
Knoxville, TN 37919-5079
Mailing address
5417 Holston Hills Rd
Knoxville, TN 37914-5131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P1043 | Other | TN | NONE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P1043 | TN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1265991673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5417 HOLSTON HILLS RD",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379145131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 FOREST CT",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379195079",
"telephone_number": "865-673-8888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-15",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "P1043",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONE",
"identifier": "P1043",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.