NPIMap

Organization Active NPI

Stellar Inc

  • Clinical Psychologist
  • Shelbyville, TN
National Provider Identifier
1346278934
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
STELLAR INC
Practice address
107 Holland St
Shelbyville, TN 37160-3927
Phone
(931) 680-4370
Fax
(931) 680-4370
NPI assigned
Jun 30, 2006
Last updated
Jan 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

Authorized official

Name
Mr. James M Reavis
Title
President
Phone
(615) 347-4508

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

107 Holland St
Shelbyville, TN 37160-3927

Mailing address

PO Box 743
Lebanon, TN 37088-0743
Phone (931) 680-4370

Other identifiers 1

IdentifierTypeStateIssuer
89000954MedicaidKY

National Provider Directory

National Provider Directory

Locations

107 Holland St
Shelbyville, TN 37160
Phone (931) 680-4370

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200009600000",
    "number": "1346278934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370880743",
            "telephone_number": "931-680-4370",
            "fax_number": "931-680-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 HOLLAND ST",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371603927",
            "telephone_number": "931-680-4370",
            "fax_number": "931-680-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STELLAR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2008-01-11",
        "status": "A",
        "authorized_official_last_name": "REAVIS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-347-4508",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89000954",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.