Gary a. Wishart, Psy.D., PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

P0000001915 Issued in TN

Legal business name

GARY A. WISHART, PSY.D., PLLC

Practice address

601 Volunteer Pkwy
Suite G
Bristol, TN 37620-3653

Phone

(423) 652-2212

Fax

(423) 652-2212

NPI assigned

Jul 2, 2012

Organization subpart

No

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

Authorized official

Name

Gary Austin Wishart, PSY.D.NPI 1982775821

Title

Owner

Phone

(423) 652-2212

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

Practitioners 1

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

• Gary Austin Wishart, PSYD

  • Clinical Psychologist
  • Bristol, TN
  • NPI 1982775821
  NPD (past) Authorized official

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341187200000",
    "number": "1780948950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 VOLUNTEER PKWY",
            "address_2": "SUITE G",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376203653",
            "telephone_number": "423-652-2212",
            "fax_number": "423-652-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 VOLUNTEER PKWY",
            "address_2": "SUITE G",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376203653",
            "telephone_number": "423-652-2212",
            "fax_number": "423-652-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY A. WISHART, PSY.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-02",
        "last_updated": "2012-07-02",
        "status": "A",
        "authorized_official_last_name": "WISHART",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "AUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-652-2212",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "TN",
            "license": "P0000001915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004551019",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "00610001154",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "104229",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "0181971",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALL INSURANCE CARRIERS AND MEDICARE",
            "identifier": "1982775821",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM OF VIRGINIA",
            "identifier": "085256",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Macy Garber
• Katlyn Gardner
• Nathan Edward Gargus, M.D.
• Christopher Garner, M.D.
• Caitlyn Garrett
• Gary W. Neal MD, PLLC
• Lucas Vance Gaskins
• Gastroenterology Associates
• Eva Marie Gatscher, NBCC, LPC
• Jean Murray Gay-Asher, LMFT

• Psychologist in Bristol, TN
• Providers in Bristol, TN by specialty
• Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.