Active NPI
Rebecca Mills Skadberg
- Clinical Psychologist
- Knoxville, TN
National Provider Identifier
1568080091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4025
- Practice address
- 8033 Ray Mears Blvd
Knoxville, TN 37919-5458 - Phone
- (865) 545-4592
- NPI assigned
- Jul 10, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | 4025 | TN | Primary |
Addresses
Primary practice location
8033 Ray Mears Blvd
Knoxville, TN 37919-5458
Mailing address
8033 Ray Mears Blvd
Knoxville, TN 37919-5458
Phone (865) 545-4592
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4025 | TN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738886400000",
"number": "1568080091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8033 RAY MEARS BLVD",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379195458",
"telephone_number": "865-545-4592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8033 RAY MEARS BLVD",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379195458",
"telephone_number": "865-545-4592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKADBERG",
"first_name": "REBECCA",
"middle_name": "MILLS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-10",
"last_updated": "2025-02-07",
"certification_date": "2025-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "4025",
"primary": true
}
],
"identifiers": [],
"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 Feb 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.