Pediatric Adolescent Center

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2676 Issued in TN

Legal business name

PEDIATRIC ADOLESCENT CENTER

Practice address

882 Willow Tree Cir Ste 201
Cordova, TN 38018-3118

Phone

(901) 757-3520

Fax

(901) 737-3807

NPI assigned

May 31, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Melissa Renea Hall

Title

Front Desk Manager

Phone

(901) 757-3520

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497956825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 WILLOW TREE CIR STE 201",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380183118",
            "telephone_number": "901-757-3520",
            "fax_number": "901-737-3807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 WILLOW TREE CIR STE 201",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380183118",
            "telephone_number": "901-757-3520",
            "fax_number": "901-737-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ADOLESCENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "RENEA",
        "authorized_official_title_or_position": "FRONT DESK MANAGER",
        "authorized_official_telephone_number": "901-757-3520",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "TN",
            "license": "2676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Schrice Patterson, FNP
• Paula Mechelle Martin Inc.
• Brittany Alyssa Payne, LMSW
• Carrie Peacock, M.S., BCBA
• Miajenell Jasmine Peake
• Pediatric Physicians, P.C.
• Pediatrics East Inc
• Matthew Glen Peifer, MS
• Cara Beth Pendley
• Zachary Pepper

• Psychologist in Cordova, TN
• Providers in Cordova, TN by specialty
• Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.