Susan Ackerman Ross, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P1062 Issued in TN

Practice address

6263 Poplar Ave
Suite 932
Memphis, TN 38119-4701

Phone

(901) 763-2188

Fax

(901) 683-5926

NPI assigned

Dec 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598821563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6263 POPLAR AVE",
            "address_2": "SUITE 932",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194701",
            "telephone_number": "901-763-2188",
            "fax_number": "901-683-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6263 POPLAR AVE",
            "address_2": "SUITE 932",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194701",
            "telephone_number": "901-763-2188",
            "fax_number": "901-683-5926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "SUSAN",
        "middle_name": "ACKERMAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P1062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jashell Ross, LPN
• Jordan Ross, MD
• Marco Ross, MD
• Marim Ross, DDS
• Stanley Ross
• Tomisha V. Ross, FNP-BC
• Amy Marie Rost, NP
• Amanda Rotenberry, F,N,P.
• Amanda Nichole Roth, CPHT
• Rebecca A Rothrock, MD

• Clinical Psychologist in Memphis, TN
• Providers in Memphis, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.