Active NPI
Landon Self
- Professional Counselor
- Cordova, TN
National Provider Identifier
1598144636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3058
- Practice address
- 58 Timber Creek Dr
Cordova, TN 38018-4233 - Phone
- (901) 566-1002
- Fax
- (901) 566-1951
- NPI assigned
- May 21, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3058 | TN | Primary |
Addresses
Primary practice location
58 Timber Creek Dr
Cordova, TN 38018-4233
Mailing address
58 Timber Creek Dr
Cordova, TN 38018-4233
Phone (901) 566-1002
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 |
|---|---|---|---|
| 3058 | TN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432166400000",
"number": "1598144636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "58 TIMBER CREEK DR",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380184233",
"telephone_number": "901-566-1002",
"fax_number": "901-566-1951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "58 TIMBER CREEK DR",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380184233",
"telephone_number": "901-566-1002",
"fax_number": "901-566-1951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELF",
"first_name": "LANDON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-21",
"last_updated": "2015-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "3058",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cordova, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.