Alicia Luscomb Autry, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PROVISIONAL 3440 Issued in TN

Practice address

7516 Enterprise Ave
Suite 1
Germantown, TN 38138-3802

Phone

(901) 755-5802

Fax

(901) 757-2249

NPI assigned

Oct 14, 2016

Last updated

Oct 14, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Germantown Psychological Associates PCGroup PAC ID 3779537667, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Germantown Psychological Associates PC

  • Psychologist
  • Germantown, TN
  • NPI 1497718639
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1528519576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7516 ENTERPRISE AVE",
            "address_2": "SUITE 1",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383802",
            "telephone_number": "901-755-5802",
            "fax_number": "901-757-2249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7516 ENTERPRISE AVE",
            "address_2": "SUITE 1",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383802",
            "telephone_number": "901-755-5802",
            "fax_number": "901-757-2249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUTRY",
        "first_name": "ALICIA",
        "middle_name": "LUSCOMB",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-14",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "PROVISIONAL 3440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Nichole Atcherson, O.D.
• Valerie Louise Augustus, MD
• Jesse Ault
• Marisa Kay Austin, ACNP
• Autism Centers of Tennessee
• Marva Joan Aven, AU.D.
• Barry L Avent, FNP
• Danielle Deanna Avery, APRN
• Thaddeus O'Brien Avery II, MS, ATC, LAT
• John A Avgeris, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.