Active NPI
Rickey Lee Bates, PH.D.
- Psychologist
- Memphis, TN
National Provider Identifier
1336734649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3738
- Practice address
- 1030 Jefferson Ave
Memphis, TN 38104-2127 - Phone
- (901) 523-8990
- NPI assigned
- Mar 8, 2021
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3738 | TN | Primary |
Addresses
Primary practice location
1030 Jefferson Ave
Memphis, TN 38104-2127
Mailing address
1375 Agnes PL
Memphis, TN 38104-4725
Phone (901) 218-1612
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 |
|---|---|---|---|
| 3738 | TN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1336734649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1375 AGNES PL",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381044725",
"telephone_number": "901-218-1612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 JEFFERSON AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381042127",
"telephone_number": "901-523-8990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BATES",
"first_name": "RICKEY",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-08",
"last_updated": "2021-03-08",
"certification_date": "2021-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": "TN",
"license": "3738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.