Individual provider Active NPI

James M. Dodson, PSYD

  • Psychologist
  • Clarksville, TN
National Provider Identifier
1508923129
Registry record updated Nov 5, 2021
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Aug 20, 2024.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1942 Issued in TN
Practice address
298 Warfield Blvd
Suite B
Clarksville, TN 37043-1828
Phone
(931) 494-7131
Fax
(931) 548-1776
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1942 TN
Psychologist 103T00000X 1942 TN Primary

Addresses

Primary practice location

298 Warfield Blvd
Suite B
Clarksville, TN 37043-1828

Mailing address

775 Weatherly Dr
Ste F
Clarksville, TN 37043-8915
Phone (931) 494-7131

Other identifiers 1

IdentifierTypeStateIssuer
1519218MedicaidTN

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1942TNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Athena Consulting and Psychological Services, PLLC Clinical CurrentSince Dec 1, 2012 Accepting new patients
Tennessee TMS Center, PLLC PastSince Jul 4, 2018 Accepting new patients

Locations

775 Weatherly Dr
Ste F
Clarksville, TN 37043
Phone (877) 641-1155

1720 West End Ave
Ste 240
Nashville, TN 37203
Phone (615) 861-1000

Organizations & group practices 2

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1508923129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 WEATHERLY DR",
            "address_2": "STE F",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438915",
            "telephone_number": "931-494-7131",
            "fax_number": "931-548-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 WARFIELD BLVD",
            "address_2": "SUITE B",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431828",
            "telephone_number": "931-494-7131",
            "fax_number": "931-548-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODSON",
        "first_name": "JAMES",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "1942",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "1942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1519218",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.