Individual provider Active NPI

Mark A. Lemay, PH.D.

  • Clinical Psychologist
  • Jefferson City, TN
National Provider Identifier
1447243480
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P1494 Issued in TN
Practice address
222 E Broadway Blvd
Ste. 203
Jefferson City, TN 37760-2837
Phone
(865) 475-9199
Fax
(865) 475-9193
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P1494 TN Primary

Addresses

Primary practice location

222 E Broadway Blvd
Ste. 203
Jefferson City, TN 37760-2837

Mailing address

222 E Broadway Blvd
Ste. 203
Jefferson City, TN 37760-2837
Phone (865) 475-9199

Other identifiers 1

IdentifierTypeStateIssuer
3682771MedicaidTN

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
I20150415000535 TN Practitioner - Clinical Psychologist 0042483752 Practice locations: Knoxville, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5308 Green Valley Dr
Knoxville, TN 37914-5114
Phone (865) 368-9445

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P1494TNMDClinical Psychologist
1494TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lemay Psychological Services Clinical PastSince Apr 30, 2003 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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1447243480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E BROADWAY BLVD",
            "address_2": "STE. 203",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602837",
            "telephone_number": "865-475-9199",
            "fax_number": "865-475-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E BROADWAY BLVD",
            "address_2": "STE. 203",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602837",
            "telephone_number": "865-475-9199",
            "fax_number": "865-475-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMAY",
        "first_name": "MARK",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P1494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3682771",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, TN

Sources for this page

Verify at the official NPI Registry.