Dr Karen a Tennyson LLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

35SI00448700 Issued in NJ

Legal business name

DR KAREN A TENNYSON LLC

Practice address

201 Pleasant Hill Rd
Chester, NJ 07930-2141

Phone

(973) 556-8462

Fax

(972) 252-6418

NPI assigned

Jun 21, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Karen Tennyson, PH.D.NPI 1154530129

Title

Psychologist

Phone

(973) 556-8462

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karen Ann Tennyson, PH.D.

  • Clinical Neuropsychologist
  • East Orange, NJ
  • NPI 1154530129
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541635200000",
    "number": "1770077752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 CONNELLY AVE",
            "city": "BUDD LAKE",
            "state": "NJ",
            "postal_code": "078282526",
            "telephone_number": "973-556-8462",
            "fax_number": "973-252-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PLEASANT HILL RD",
            "city": "CHESTER",
            "state": "NJ",
            "postal_code": "079302141",
            "telephone_number": "973-556-8462",
            "fax_number": "972-252-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR KAREN A TENNYSON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-21",
        "last_updated": "2018-11-08",
        "status": "A",
        "authorized_official_last_name": "TENNYSON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "973-556-8462",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "35SI00448700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0153265",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Chester, NJ
• Providers in Chester, NJ by specialty
• Clinical Neuropsychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.