Individual provider Active NPI

Paul Deschenes, PSY.D.

  • Clinical Psychologist
  • Jackson, TN
National Provider Identifier
1699726216
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P0000000897 Issued in TN
Practice address
174 Murray Guard Dr Ste B
Jackson, TN 38305-3742
Phone
(731) 660-0199
Fax
(731) 660-3650
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P0000000897 TN Primary

Addresses

Primary practice location

174 Murray Guard Dr Ste B
Jackson, TN 38305-3742

Mailing address

174 Murray Guard Dr Ste B
Jackson, TN 38305-3742
Phone (731) 660-0199

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
I20110927000097 TN Practitioner - Clinical Psychologist 0840461752 Practice locations: Jackson, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

367 B N Pkwy
Suite 1
Jackson, TN 38305-2899
Phone (731) 668-2277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
David Pickering Clinical PastSince Apr 1, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1699726216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 MURRAY GUARD DR STE B",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053742",
            "telephone_number": "731-660-0199",
            "fax_number": "731-660-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 MURRAY GUARD DR STE B",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053742",
            "telephone_number": "731-660-0199",
            "fax_number": "731-660-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESCHENES",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P0000000897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.