Organization Active NPI

Psychiatry Group PLLC

  • Psychiatry Physician
  • Bartlett, TN
National Provider Identifier
1932204690
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PSYCHIATRY GROUP PLLC
Practice address
3173 Kirby Whitten Rd
#104
Bartlett, TN 38134
Phone
(901) 384-8040
Fax
(901) 309-8784
NPI assigned
Sep 14, 2006
Last updated
Nov 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Authorized official

Name
Kim Combs
Title
Billing and Finance
Phone
(901) 384-8040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X TN Primary

Addresses

Primary practice location

3173 Kirby Whitten Rd
#104
Bartlett, TN 38134

Mailing address

3173 Kirby Whitten Rd Ste 104
Bartlett, TN 38134-2881
Phone (901) 384-8040

Other identifiers 1

IdentifierTypeStateIssuer
3719897MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041027000528 TN Part B Supplier - Clinic/Group Practice 1456313006 Receives reassigned benefits from 8 practitioners
Practice locations: Bartlett, TN

National Provider Directory

National Provider Directory

Locations

3173 Kirby Whitten Rd
Ste 104
Bartlett, TN 38134
Phone (901) 384-3606

Practitioners & affiliated clinicians

Practitioners 8

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": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731024000000",
    "number": "1932204690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3173 KIRBY WHITTEN RD STE 104",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381342881",
            "telephone_number": "901-384-8040",
            "fax_number": "901-888-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3173 KIRBY WHITTEN RD",
            "address_2": "#104",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "38134",
            "telephone_number": "901-384-8040",
            "fax_number": "901-309-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRY GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A",
        "authorized_official_last_name": "COMBS",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "BILLING AND FINANCE",
        "authorized_official_telephone_number": "901-384-8040"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3719897",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.