Active NPI
Bruce L. Keisling, DR.
- Clinical Psychologist
- Memphis, TN
National Provider Identifier
1699881318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P0000002219
- Practice address
- 711 Jefferson Ave
Memphis, TN 38105-5003 - Phone
- (901) 448-6511
- Fax
- (901) 448-7097
- NPI assigned
- Aug 23, 2006
- Last updated
- Sep 11, 2025
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | P0000002219 | TN | |
| Clinical Psychologist | 103TC0700X | P0000002219 | TN | Primary |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | P0000002219 | TN |
Addresses
Primary practice location
711 Jefferson Ave
Memphis, TN 38105-5003
Mailing address
711 Jefferson Ave
Memphis, TN 38105-5003
Phone (901) 448-6511
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P0000002219 | TN | MD | Intellectual & Developmental Disabilities Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Tennessee | Past | Accepting new patients | |
| University of Tennessee | Past | Accepting new patients | |
| Team Centers Inc | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Center on Developmental Disabilities
- Developmental Disabilities Clinic/Center
- Memphis, TN
- NPI 1427064880
-
- Psychologist
- Chattanooga, TN
- NPI 1992793012
-
dba Univ. of TN Health Science Center College of Nursing
- Family Nurse Practitioner
- Memphis, TN
- NPI 1174221337
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1699881318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 JEFFERSON AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381055003",
"telephone_number": "901-448-6511",
"fax_number": "901-448-7097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 JEFFERSON AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381055003",
"telephone_number": "901-448-6511",
"fax_number": "901-448-7097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEISLING",
"first_name": "BRUCE",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "DR.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-23",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "TN",
"license": "P0000002219",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "P0000002219",
"primary": true
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "TN",
"license": "P0000002219",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.