Active NPI
Randall Edward Jessee, PHD
- Counselor
- Johnson City, TN
National Provider Identifier
1427187947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPC90
- Practice address
- 607 Baxter St
Fairview Associates
Johnson City, TN 37604 - Phone
- (423) 232-2670
- Fax
- (423) 928-0381
- NPI assigned
- Mar 2, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPC90 | TN | Primary |
Addresses
Primary practice location
607 Baxter St
Fairview Associates
Johnson City, TN 37604
Mailing address
Box 9054
11675 Spratlin Park Dr
Gray, TN 37615
Phone (423) 467-3720
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 |
|---|---|---|---|
| LPC90 | TN | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427187947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BOX 9054",
"address_2": "11675 SPRATLIN PARK DR",
"city": "GRAY",
"state": "TN",
"postal_code": "37615",
"telephone_number": "423-467-3720",
"fax_number": "423-467-3710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "607 BAXTER ST",
"address_2": "FAIRVIEW ASSOCIATES",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "37604",
"telephone_number": "423-232-2670",
"fax_number": "423-928-0381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JESSEE",
"first_name": "RANDALL",
"middle_name": "EDWARD",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TN",
"license": "LPC90",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.