Individual provider Active NPI

Jennifer S McKelvey, PH.D.

  • Clinical Psychologist
  • Knoxville, TN
National Provider Identifier
1912308461
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4029 Issued in TN
Practice address
10133 Sherrill Blvd Ste 220
Knoxville, TN 37932-3775
Phone
(615) 320-1155
Fax
(615) 320-1177
NPI assigned
Sep 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 020639 NY
Clinical Psychologist 103TC0700X 4029 TN Primary

Addresses

Primary practice location

10133 Sherrill Blvd Ste 220
Knoxville, TN 37932-3775

Mailing address

220 Athens Way Ste 104
Nashville, TN 37228-1351
Phone (615) 320-1155

Other practice location 1

3733 61st St
Apt. 3C
Woodside, NY 11377-2543
Phone (917) 586-6506

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
I20250118000068 TN Practitioner - Clinical Psychologist 6305168576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athena Consulting and Psychological Services, PLLCGroup PAC ID 5294719795, 60 clinicians

Practice addresses (Care Compare)

10133 Sherrill Blvd
Suite 220
Knoxville, TN 37932-3347
Phone (615) 320-1155

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020639NYMDClinical Psychologist
4029TNMDVeterinarian

Practice roles

OrganizationSpecialtyStatusNew patients
Athena Consulting and Psychological Services, PLLC Clinical CurrentSince Nov 5, 2024 Accepting new patients

Locations

109 Hazel Path
Ste 4
Hendersonvlle, TN 37075
Phone 6153201155 ext. 232

10133 Sherrill Blvd
Ste 220
Knoxville, TN 37932
Phone (776) 641-1155

220 Athens Way
Ste 104
Nashville, TN 37228
Phone (615) 380-4725

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": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1912308461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 ATHENS WAY STE 104",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281351",
            "telephone_number": "615-320-1155",
            "fax_number": "615-320-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10133 SHERRILL BLVD STE 220",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379323775",
            "telephone_number": "615-320-1155",
            "fax_number": "615-320-1177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3733 61st St",
            "address_2": "Apt. 3C",
            "address_purpose": "LOCATION",
            "city": "Woodside",
            "state": "NY",
            "postal_code": "113772543",
            "country_code": "US",
            "telephone_number": "917-586-6506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKELVEY",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-15",
        "last_updated": "2025-02-21",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "020639",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "4029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.