Individual provider Active NPI

Sheena Elizabeth Rose, PHD

  • Psychologist
  • Germantown, TN
National Provider Identifier
1396836409
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
P839 Issued in TN
Practice address
1922 Exeter Road
Suite 106
Germantown, TN 38138
Phone
(901) 759-0984
Fax
(662) 838-6724
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X P839 TN Primary

Addresses

Primary practice location

1922 Exeter Road
Suite 106
Germantown, TN 38138

Mailing address

1922 Exeter Road
Suite 106
Germantown, TN 38138
Phone (901) 759-0984

Other identifiers 2

IdentifierTypeStateIssuer
3008998MedicaidTN
44706OtherNATIONAL REGISTER

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110125001148 TN Practitioner - Clinical Psychologist 9032398896 Practice locations: Germantown, TN; Memphis, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1922 Exeter Rd
Germantown, TN 38138-2949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
P839TNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mealer Psychological,PLLC PastSince Jul 17, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396836409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 EXETER ROAD",
            "address_2": "SUITE 106",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "38138",
            "telephone_number": "901-759-0984",
            "fax_number": "662-838-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 EXETER ROAD",
            "address_2": "SUITE 106",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "38138",
            "telephone_number": "901-759-0984",
            "fax_number": "662-838-6724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "SHEENA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "P839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3008998",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL REGISTER",
            "identifier": "44706",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.