Organization Active NPI

Trinity Behavioral Medicine, PLLC

  • Psychiatry Physician
  • Cleveland, TN
National Provider Identifier
1861914350
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
DO933 Issued in TN
Legal business name
TRINITY BEHAVIORAL MEDICINE, PLLC
Practice address
4363 Ocoee St N Ste 3
Cleveland, TN 37312-4894
Phone
(423) 464-6272
Fax
(423) 813-7110
NPI assigned
Jul 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Richard Kenneth Fisher Jr., DONPI 1760413678
Title
Psychiatrist
Phone
(423) 464-6272

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X DO933 TN Primary

Addresses

Primary practice location

4363 Ocoee St N Ste 3
Cleveland, TN 37312-4894

Mailing address

4363 Ocoee St N Ste 3
Cleveland, TN 37312-4894
Phone (423) 464-6272

National Provider Directory

National Provider Directory

Locations

4363 Ocoee St N
Ste 3
Cleveland, TN 37312
Phone (423) 464-6272

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1861914350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4363 OCOEE ST N STE 3",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124894",
            "telephone_number": "423-464-6272",
            "fax_number": "423-813-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4363 OCOEE ST N STE 3",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124894",
            "telephone_number": "423-464-6272",
            "fax_number": "423-813-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY BEHAVIORAL MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-17",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "423-464-6272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "DO933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.