Active NPI
Karen Rene Gannon, PSY.D.
- Clinical Psychologist
- Knoxville, TN
National Provider Identifier
1548269236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P2460
- Practice address
- 9031 Cross Park Dr
Knoxville, TN 37923-4602 - Phone
- (865) 545-4592
- NPI assigned
- Jul 15, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | P2460 | TN | Primary |
Addresses
Primary practice location
9031 Cross Park Dr
Knoxville, TN 37923-4602
Mailing address
9031 Cross Park Dr
Knoxville, TN 37923-4602
Phone (865) 545-4592
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3585339 | Medicaid | TN |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P2460 | TN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267920000000",
"number": "1548269236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9031 CROSS PARK DR",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379234602",
"telephone_number": "865-545-4592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9031 CROSS PARK DR",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379234602",
"telephone_number": "865-545-4592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANNON",
"first_name": "KAREN",
"middle_name": "RENE",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-15",
"last_updated": "2010-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "P2460",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3585339",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.