Active NPI
David Michael Winecoff, PH.D.
- Clinical Psychologist
- Knoxville, TN
National Provider Identifier
1356567002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P-1465
- Practice address
- 3711 Sutherland Ave
Knoxville, TN 37919-4338 - Phone
- (865) 450-9702
- Fax
- (865) 450-9702
- NPI assigned
- Apr 18, 2007
- 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 | P-1465 | TN | Primary |
Addresses
Primary practice location
3711 Sutherland Ave
Knoxville, TN 37919-4338
Mailing address
3711 Sutherland Ave
Knoxville, TN 37919-4338
Phone (865) 450-9702
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4106843 | Other | TN | BLUE CROSS PROVIDER # |
| 3684074 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2019 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P-1465 | TN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263859200000",
"number": "1356567002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3711 SUTHERLAND AVE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379194338",
"telephone_number": "865-450-9702",
"fax_number": "865-450-9702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3711 SUTHERLAND AVE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379194338",
"telephone_number": "865-450-9702",
"fax_number": "865-450-9702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINECOFF",
"first_name": "DAVID",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-18",
"last_updated": "2010-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "P-1465",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER #",
"identifier": "4106843",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3684074",
"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 Jan 19, 2010; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.