Organization Active NPI

Comprehensive Psychological Services PC

  • Clinical Psychologist
  • Knoxville, TN
National Provider Identifier
1982646428
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P1947 Issued in TN
Legal business name
COMPREHENSIVE PSYCHOLOGICAL SERVICES PC
Practice address
108 West Summit Hill Drive
Knoxville, TN 37902
Phone
(865) 525-1099
Fax
(865) 525-7494
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Authorized official

Name
Dr. Pamela D Jones, PSYDNPI 1669512364
Title
Psychologist Owner
Phone
(865) 525-1099

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X P1947 TN Primary

Addresses

Primary practice location

108 West Summit Hill Drive
Knoxville, TN 37902

Mailing address

108 West Summit Hill Drive
Knoxville, TN 37902
Phone (865) 525-1099

Other identifiers 2

IdentifierTypeStateIssuer
3982642MedicaidTN
4056695OtherTNBCBS TN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120404000703 TN Part B Supplier - Clinic/Group Practice 0446410104 Receives reassigned benefits from 1 practitioner
Practice locations: Knoxville, TN

National Provider Directory

National Provider Directory

Locations

2210 Sutherland Ave
Ste 114
Knoxville, TN 37919
Phone (865) 525-1099

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320019200000",
    "number": "1982646428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 WEST SUMMIT HILL DRIVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37902",
            "telephone_number": "865-525-1099",
            "fax_number": "865-525-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 WEST SUMMIT HILL DRIVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37902",
            "telephone_number": "865-525-1099",
            "fax_number": "865-525-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE PSYCHOLOGICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2011-10-31",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PSYCHOLOGIST OWNER",
        "authorized_official_telephone_number": "865-525-1099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P1947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3982642",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "4056695",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.