Active NPI
Jennifer Bolden, PH.D.
- Psychologist
- Knoxville, TN
National Provider Identifier
1346705506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- P0000003424
- Practice address
- 5217 Brig LN
Knoxville, TN 37914-2824 - Phone
- (850) 443-2201
- NPI assigned
- Feb 1, 2019
- Sex
- Female
- 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 | P0000003424 | TN | Primary |
Addresses
Primary practice location
5217 Brig LN
Knoxville, TN 37914-2824
Mailing address
5217 Brig LN
Knoxville, TN 37914-2824
Phone (850) 443-2201
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 |
|---|---|---|---|
| P0000003424 | TN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548979200000",
"number": "1346705506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5217 BRIG LN",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379142824",
"telephone_number": "850-443-2201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5217 BRIG LN",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379142824",
"telephone_number": "850-443-2201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLDEN",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-01",
"last_updated": "2019-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TN",
"license": "P0000003424",
"primary": true
}
],
"identifiers": [],
"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 Feb 1, 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.