Individual provider Active NPI

Gary Lee Tenney, PH.D.

  • Psychologist
  • Gilbert, AZ
National Provider Identifier
1770019762
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4847 Issued in AZ
Practice address
428 S Gilbert Rd
Suite 109
Gilbert, AZ 85296-2263
Phone
(480) 749-4655
Fax
(480) 750-1632
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4847 AZ Primary

Addresses

Primary practice location

428 S Gilbert Rd
Suite 109
Gilbert, AZ 85296-2263

Mailing address

428 S Gilbert Rd
Suite 109
Gilbert, AZ 85296-2263
Phone (480) 749-4655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20171208002284 AZ Practitioner - Clinical Psychologist 4385918986 Practice locations: Gilbert, AZ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

428 S Gilbert Rd
Suite 109
Gilbert, AZ 85296-2262
Phone (480) 749-4655

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4847AZMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1770019762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 S GILBERT RD",
            "address_2": "SUITE 109",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852962263",
            "telephone_number": "480-749-4655",
            "fax_number": "480-750-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 S GILBERT RD",
            "address_2": "SUITE 109",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852962263",
            "telephone_number": "480-749-4655",
            "fax_number": "480-750-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNEY",
        "first_name": "GARY",
        "middle_name": "LEE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "4847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.