Individual provider Active NPI

Anne Whitney, PH.D.

  • Clinical Psychologist
  • Knoxville, TN
National Provider Identifier
1538218375
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P1240 Issued in TN
Practice address
1111 N Northshore Dr
Suite S-490
Knoxville, TN 37919-4005
Phone
(865) 584-0171
Fax
(865) 584-0171
NPI assigned
Jan 10, 2007
Last updated
Jan 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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 P1240 TN Primary

Addresses

Primary practice location

1111 N Northshore Dr
Suite S-490
Knoxville, TN 37919-4005

Mailing address

1111 N Northshore Dr
Suite S-490
Knoxville, TN 37919-4005
Phone (865) 584-0171

Other identifiers 2

IdentifierTypeStateIssuer
3074492OtherTNBLUE CROSS BLUE SHIELD
3685211MedicaidTN

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
I20111108000123 TN Practitioner - Clinical Psychologist 0244403293 Reassigns benefits to 1 organization
Practice locations: Knoxville, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Northshore Group IncGroup PAC ID 7012374929, 16 clinicians

Practice addresses (Care Compare)

1111 N Northshore Dr
Suite S490
Knoxville, TN 37919-2808
Phone (865) 584-0171

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1240TNMDBehavioral Analyst
P1240TNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Northshore Group, Inc. Clinical CurrentSince Jun 1, 2023 Accepting new patients

Locations

1111 N Northshore Dr
Ste S490
Knoxville, TN 37919
Phone (865) 584-0171

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1538218375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N NORTHSHORE DR",
            "address_2": "SUITE S-490",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194005",
            "telephone_number": "865-584-0171",
            "fax_number": "865-584-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N NORTHSHORE DR",
            "address_2": "SUITE S-490",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194005",
            "telephone_number": "865-584-0171",
            "fax_number": "865-584-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITNEY",
        "first_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P1240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3074492",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3685211",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.