Individual provider Active NPI

Cheri L Premeau, PH.D.

  • Health Service Psychologist
  • Clarksville, TN
National Provider Identifier
1710034277
Registry record updated Jul 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
1717 Issued in TN
Practice address
1891 Old Trenton Road
Clarksville, TN 37040
Phone
(931) 552-4171
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X 1717 TN Primary
Clinical Psychologist 103TC0700X 1717 TN

Addresses

Primary practice location

1891 Old Trenton Road
Clarksville, TN 37040

Mailing address

PO Box 30429
Clarksville, TN 37040-0008
Phone (931) 552-4171

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
I20070728000313 TN Practitioner - Clinical Psychologist 9739280173 Practice locations: Clarksville, TN; Waverly, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Vanderbilt University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1891 Old Trenton Rd
Clarksville, TN 37040-6734
Phone (931) 552-4171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1717TNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Paradigm Health Services, Inc Past Accepting new patients
Family Wellness Center of Clarksville, PC Clinical Past Accepting new patients

Organizations & group practices 2

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373846400000",
    "number": "1710034277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30429",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370400008",
            "telephone_number": "931-552-4171",
            "fax_number": "931-551-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 OLD TRENTON ROAD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37040",
            "telephone_number": "931-552-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREMEAU",
        "first_name": "CHERI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "TN",
            "license": "1717",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "1717",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.