Individual provider Active NPI

Herman Paul Stanley Jr., PHD

  • Psychologist
  • Memphis, TN
National Provider Identifier
1942247937
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
P0000000997 Issued in TN
Practice address
3150 Lenox Park Blvd
Suite 214
Memphis, TN 38115-4299
Phone
(901) 273-2368
Fax
(901) 273-2351
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X P0000000997 TN Primary

Addresses

Primary practice location

3150 Lenox Park Blvd
Suite 214
Memphis, TN 38115-4299

Mailing address

3150 Lenox Park Blvd
Suite 214
Memphis, TN 38115-4299
Phone (901) 273-2368

Other identifiers 1

IdentifierTypeStateIssuer
3685276MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P0000000997TNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psycare LLC Psychologist CurrentSince Dec 1, 2018 Accepting new patients

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213056000000",
    "number": "1942247937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 LENOX PARK BLVD",
            "address_2": "SUITE 214",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381154299",
            "telephone_number": "901-273-2368",
            "fax_number": "901-273-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 LENOX PARK BLVD",
            "address_2": "SUITE 214",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381154299",
            "telephone_number": "901-273-2368",
            "fax_number": "901-273-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "HERMAN",
        "middle_name": "PAUL",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2008-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "P0000000997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3685276",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.