Connie Joy Daniel, EDD
Individual provider Active NPI Clinical Psychologist · Chattanooga, TN
NPI 1750488201 · NPPES record last updated Feb 13, 2008
Key facts
- NPI
- 1750488201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- P0000002092 (TN)
- Practice address
- 6110 Shallowford Rd
C O CRC for Paradigm
Chattanooga, TN 37421-1894 - Phone
- (800) 632-6074
- Fax
- (866) 341-7509
- NPI assigned
- Sep 19, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Brownsville Medical Clinic, P.a.
BH Services Southeast 1 PC
NV Pacs 2 LLC
Practice addresses (Care Compare)
2565 N Washington Ave
Brownsville, TN 38012-1610
841 W James M Campbell Blvd
Columbia, TN 38401-4668
Phone (931) 388-5035
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.72 of 100
- Quality
- 72.97
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040828000211 | TN | Practitioner - Clinical Psychologist | 0143295659 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P0000002092 | TN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ipc Pac Healthcare Services of Tennessee PC | Current |
Accepting new patients | |
| NV Pacs 2 LLC | Current |
Accepting new patients | |
| CS Pacs 3 Southeast, LLC | Current |
Accepting new patients | |
| BH Services Southeast 1 PC | Current |
Accepting new patients |
Locations
18 N Cavalier Dr
Alamo, TN 38001
Phone (731) 696-4500
841 W James M Campbell Blvd
Columbia, TN 38401
Phone (931) 388-5035
880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669
809 E Emerald Ave
Knoxville, TN 37917
Phone (865) 524-7366
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | P0000002092 | TN | Yes |
Addresses
Primary practice location
6110 Shallowford Rd
C O CRC for Paradigm
Chattanooga, TN 37421-1894
Mailing address
3205 Vera Valley Rd
Franklin, TN 37064
Phone (615) 591-6507
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4090359 | Other | TN | BCBS |
| P00242852 | Other | TN | RAILROAD MEDICARE |
| 3981313 | Medicaid | TN |
Other providers in Chattanooga, TN
- Amanda Lynn Dallas
- Jill Robinson Danahy
- Marie Dance
- Ngoc Binh Dang
- Brooke E. Daniel
- Davey B. Daniel
- Erica Daniel
- Jonathan Andrew Daniel
- Kristen Daniel
- Tonya A. Daniel
All providers in Chattanooga, TN · Clinical Psychologist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.