Robert Matthew Tolliver, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3437 Issued in TN

Practice address

325 N. State of Franklin Road, Ground Floor
Johnson City, TN 37604-6062

Phone

(423) 439-7320

Fax

(423) 739-7343

NPI assigned

Aug 7, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Medical Education Assistance Corporation

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1235180480
  Medicare reassignment NPD

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1285043810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6350 W ANDREW JOHNSON HWY",
            "address_2": "DEPARTMENT 100",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "378778605",
            "telephone_number": "800-355-3565",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N. STATE OF FRANKLIN ROAD, GROUND FLOOR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046062",
            "telephone_number": "423-439-7320",
            "fax_number": "423-739-7343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 W 5th North St",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "TN",
            "postal_code": "378143810",
            "country_code": "US",
            "telephone_number": "423-586-5032",
            "fax_number": "423-581-8473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOLLIVER",
        "first_name": "ROBERT",
        "middle_name": "MATTHEW",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-07",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "3437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q032681",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• TN Doctors of Optometry, PLLC
• Daniel L Tolan, MD
• Faith Tolan, PA
• Kara Tolbert, RBT
• Angela Dawn Tolley, PE
• Sarah Tolliver, MD
• Keegan Tomaszewski, PA-C
• Natalie Victoria Tomes, DMD
• Lindsey Toney, APN
• Wayne P Tongco, MD

• Psychologist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.

Verify at the official NPI Registry.