Individual provider Active NPI

Laura Stockdale, PH.D.

  • Clinical Psychologist
  • Knoxville, TN
National Provider Identifier
1861599334
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P0000001492 Issued in TN
Practice address
305 Westfield Dr
Knoxville, TN 37919-4824
Phone
(865) 264-2400
NPI assigned
Sep 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P0000001492 TN Primary

Addresses

Primary practice location

305 Westfield Dr
Knoxville, TN 37919-4824

Mailing address

6231 Highland Place Way
Ste 101
Knoxville, TN 37919-4083
Phone (865) 264-2400

Other identifiers 3

IdentifierTypeStateIssuer
4076563OtherTNBCBS
P00106939OtherTNRAILROAD MEDICARE
3980093MedicaidTN

Other names 1

  • Laura Stockdale Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20040128000211 TN Practitioner - Clinical Psychologist 4183527203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Behavioral Medicine Institute PCGroup PAC ID 4284828385, 21 clinicians

Practice addresses (Care Compare)

1540 Member LN
Suite 100
Knoxville, TN 37909-1231
Phone (865) 579-0552

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P0000001492TNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Medicine Institute PC Clinical CurrentSince Sep 23, 2012 Accepting new patients

Locations

6231 Highland Place Way
Ste 101
Knoxville, TN 37919
Phone (865) 264-2400

1540 Member Ln
Ste 100
Knoxville, TN 37909
Phone (865) 579-0552

305 Westfield Rd
Knoxville, TN 37919
Phone (865) 409-5001

2607 Kingston Pike
Ste 250
Knoxville, TN 37919
Phone (865) 264-2400

575 Oak Ridge Tpke
Ste 110
Oak Ridge, TN 37830
Phone (865) 579-0552

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1861599334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6231 HIGHLAND PLACE WAY",
            "address_2": "STE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194083",
            "telephone_number": "865-264-2400",
            "fax_number": "865-588-6406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 WESTFIELD DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194824",
            "telephone_number": "865-264-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKDALE",
        "first_name": "LAURA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-19",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P0000001492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4076563",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00106939",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3980093",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "STOCKDALE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.