Individual provider Active NPI

Pamela D. Jones, PSY.D.

  • Psychologist
  • Knoxville, TN
National Provider Identifier
1669512364
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1947 Issued in TN
Practice address
108 W Summit Hill Dr
Knoxville, TN 37902-1025
Phone
(865) 525-1099
Fax
(865) 525-7494
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1947 TN Primary

Addresses

Primary practice location

108 W Summit Hill Dr
Knoxville, TN 37902-1025

Mailing address

108 W Summit Hill Dr
Knoxville, TN 37902-1025
Phone (865) 525-1099

Other identifiers 2

IdentifierTypeStateIssuer
4056695OtherTNBLUE CROSS BLUE SHIELD
3981671MedicaidTN

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
I20120404000754 TN Practitioner - Clinical Psychologist 8224298997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2210 Sutherland Ave
Suite 114
Knoxville, TN 37919-2337
Phone (865) 525-1099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1947COMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Psychological Services PC CurrentSince Jul 1, 2002 Accepting new patients

Locations

2210 Sutherland Ave
Ste 114
Knoxville, TN 37919
Phone (865) 525-1099

108 W Summit Hill Dr
Knoxville, TN 37902
Phone (865) 525-1099

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669512364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W SUMMIT HILL DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379021025",
            "telephone_number": "865-525-1099",
            "fax_number": "865-525-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W SUMMIT HILL DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379021025",
            "telephone_number": "865-525-1099",
            "fax_number": "865-525-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "PAMELA",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "1947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4056695",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3981671",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.