Active NPI
Clark Andrew Stevens
- Clinical Psychologist
- Knoxville, TN
National Provider Identifier
1720234289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 30893
- Practice address
- 9724 Kingston Pike
Suite 605
Knoxville, TN 37922-3347 - Phone
- (865) 357-4673
- NPI assigned
- Aug 14, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | P0000002801 | TN | |
| Clinical Psychologist | 103TC0700X | 30893 | TX | Primary |
Addresses
Primary practice location
9724 Kingston Pike
Suite 605
Knoxville, TN 37922-3347
Mailing address
9724 Kingston Pike
Suite 605
Knoxville, TN 37922-3347
Phone (865) 357-4673
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P0000002801 | TN | MD | Psychologist |
| 30893 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235952000000",
"number": "1720234289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9724 KINGSTON PIKE",
"address_2": "SUITE 605",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379223347",
"telephone_number": "865-357-4673",
"fax_number": "865-357-4674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9724 KINGSTON PIKE",
"address_2": "SUITE 605",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379223347",
"telephone_number": "865-357-4673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "CLARK",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-08-14",
"last_updated": "2009-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TN",
"license": "P0000002801",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "30893",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.