Individual provider Active NPI

David Tierney, PHD

  • Psychologist
  • Johnson City, TN
National Provider Identifier
1962073338
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4155 Issued in TN
Practice address
615 N State of Franklin Rd
Johnson City, TN 37604-8209
Phone
(423) 930-8337
NPI assigned
Jul 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0810008866 VA
Psychologist 103T00000X 4155 TN Primary

Addresses

Primary practice location

615 N State of Franklin Rd
Johnson City, TN 37604-8209

Mailing address

PO Box 699
Mountain Home, TN 37684-0699

Other practice location 1

501 Adesa Blvd Ste A150
Lenoir City, TN 37771-6719
Phone (865) 986-8082

Other practice location 2

105 W Park Dr Ste 2A
Kingsport, TN 37660-3805
Phone (423) 930-8337

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
I20251002000231 TN Practitioner - Clinical Psychologist 7416453063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

615 N State of Franklin Rd
Johnson City, TN 37604-8209
Phone (423) 930-8337

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4155TNMDPsychologist
0810008866VAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation CurrentSince Aug 27, 2025 Accepting new patients

Locations

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

615 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 433-6039

105 W Park Dr
Ste 2A
Kingsport, TN 37660
Phone (423) 251-6702

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": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1962073338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048209",
            "telephone_number": "423-930-8337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Adesa Blvd Ste A150",
            "address_purpose": "LOCATION",
            "city": "Lenoir City",
            "state": "TN",
            "postal_code": "377716719",
            "country_code": "US",
            "telephone_number": "865-986-8082",
            "fax_number": "865-986-5890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 W Park Dr Ste 2A",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603805",
            "country_code": "US",
            "telephone_number": "423-930-8337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIERNEY",
        "first_name": "DAVID",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-07",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810008866",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "4155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.