NPIMap

Organization Active NPI

David Pickering

  • Clinical Psychologist
  • Jackson, TN
National Provider Identifier
1851569412
Registry record updated Feb 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P1223 Issued in TN
Legal business name
DAVID PICKERING
Practice address
367B N Parkway Ste 1
Jackson, TN 38305-2899
Phone
(731) 668-2277
Fax
(731) 660-0510
NPI assigned
Feb 18, 2008
Last updated
Feb 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2008

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

Authorized official

Name
David E. Pickering, PH.D.NPI 1578569604
Title
Member
Phone
(731) 668-2277

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P1223 TN Primary

Addresses

Primary practice location

367B N Parkway Ste 1
Jackson, TN 38305-2899

Mailing address

367B N Parkway Ste 1
Jackson, TN 38305-2899
Phone (731) 668-2277

Other identifiers 1

IdentifierTypeStateIssuer
3680830MedicaidTN

National Provider Directory

National Provider Directory

Locations

367B N Parkway
Ste 1
Jackson, TN 38305
Phone (731) 660-2277

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203292800000",
    "number": "1851569412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367B N PARKWAY STE 1",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052899",
            "telephone_number": "731-668-2277",
            "fax_number": "731-660-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367B N PARKWAY STE 1",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052899",
            "telephone_number": "731-668-2277",
            "fax_number": "731-660-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID PICKERING",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-18",
        "last_updated": "2008-02-18",
        "status": "A",
        "authorized_official_last_name": "PICKERING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "731-668-2277",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P1223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3680830",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2008; 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.