Individual provider Active NPI

Lance Thomas Laurence, PH.D.

  • Psychologist
  • Knoxville, TN
National Provider Identifier
1407933971
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
P000771 Issued in TN
Practice address
305 Westfield Rd
Knoxville, TN 37919-4824
Phone
(865) 584-8547
Fax
(865) 584-5932
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X P000771 TN Primary

Addresses

Primary practice location

305 Westfield Rd
Knoxville, TN 37919-4824

Mailing address

12524 Willow Cove Way
Knoxville, TN 37934-5348
Phone (865) 966-9834

Other identifiers 3

IdentifierTypeStateIssuer
226475000OtherTNMAGELLAN PROVIDER NUMBER
368700OtherTNTRIAGON/MEDIGAP PROV #
0023031OtherTNBC/BS PROVIDER NUMBER

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
I20170327000069 TN Practitioner - Clinical Psychologist 4587979281 Practice locations: Knoxville, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6231 Highland Place Way
Suite 201
Knoxville, TN 37919-4083
Phone (865) 584-8547

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P000771TNMDPsychologist
771TNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
The Westfield Center Past 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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1407933971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12524 WILLOW COVE WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379345348",
            "telephone_number": "865-966-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 WESTFIELD RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194824",
            "telephone_number": "865-584-8547",
            "fax_number": "865-584-5932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURENCE",
        "first_name": "LANCE",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "P000771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN PROVIDER NUMBER",
            "identifier": "226475000",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIAGON/MEDIGAP PROV #",
            "identifier": "368700",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER NUMBER",
            "identifier": "0023031",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.