Individual provider Active NPI

Jennifer Ann Hardy, PH.D.

  • Counseling Psychologist
  • Maryville, TN
National Provider Identifier
1962751339
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
P3102 Issued in TN
Practice address
659 Morganton Square Dr
Maryville, TN 37801-4763
Phone
(865) 337-1198
Fax
(865) 982-9428
NPI assigned
Aug 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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 P3102 TN
Counseling Psychologist 103TC1900X P3102 TN Primary

Addresses

Primary practice location

659 Morganton Square Dr
Maryville, TN 37801-4763

Mailing address

659 Morganton Square Dr
Maryville, TN 37801-4763
Phone (865) 337-1198

Other names 1

  • Jennifer Ann Norman Former name

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
I20121023000108 TN Practitioner - Clinical Psychologist 5991955288 Reassigns benefits to 1 organization
Practice locations: Maryville, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

211 Foothills Mall Dr
Maryville, TN 37801-5515
Phone (865) 337-1198

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P3102TNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Health Systems CurrentSince Aug 27, 2012 Accepting new patients
Cherokee Health Systems CurrentSince Aug 27, 2012 Accepting new patients

Locations

6350 W Andrew Johnson Hwy
Talbott, TN 37877
Phone (423) 586-5031

6350 W Andrew Johnson Hwy
#100
Talbott, TN 37877
Phone (423) 586-5031

Organizations & group practices 2

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": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1962751339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 MORGANTON SQUARE DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014763",
            "telephone_number": "865-337-1198",
            "fax_number": "865-982-9428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 MORGANTON SQUARE DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014763",
            "telephone_number": "865-337-1198",
            "fax_number": "865-982-9428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-31",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P3102",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TN",
            "license": "P3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "NORMAN",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.