DR. PEGGY JOYCE CANTRELL (NPI# 1417154410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417154410 |
| Entity Type | Individual |
| Full Name | DR. PEGGY JOYCE CANTRELL |
| Practice Address |
807 University Pkwy Etsu Campus Johnson City TN 37614-6500 |
| Mailing Address |
4 Briarwood Court Johnson City TN 37604-7677 |
| Practice Telephone | 4234397777 |
| Practice Fax Number | 4234395695 |
| Mailing Telephone | 4233601697 |
| Mailing Fax Number | 4234394472 |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2010-11-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
P-000000901 | TN | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
P00000901 | TN | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
P-000000901 | TN | Behavioral Health & Social Service Providers |
| Street Address |
807 UNIVERSITY PKWY ETSU CAMPUS |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37614-6500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811960644 | Kerry L. Holland | Psychologist | 807 University Pkwy, 139 Lucille Clement Hall, Johnson City, TN 37614-6500 | 2006-02-10 |
| 1700222585 | Mark David Linville Jr. | General Practice | 807 University Pkwy, Johnson City, TN 37614-6500 | 2013-05-20 |
| 1275877755 | Jessica Freshour | Pharmacist | 807 University Pkwy, Maple Avenue, Building 7, Suite 312, Johnson City, TN 37614-6500 | 2012-11-21 |
| 1447503198 | Mary Jo Davenport | Physical Therapist | 807 University Pkwy, Box 70403, Johnson City, TN 37614-1703 | 2012-10-18 |
| 1811240567 | David A Arnall | Physical Therapist | 807 University Pkwy, Box 70403, Johnson City, TN 37614-1703 | 2012-10-18 |
| 1144573114 | Duane A. Williams | Physical Therapist | 807 University Pkwy, Box 70403, Johnson City, TN 37614-6500 | 2012-10-16 |
| 1356694301 | William Andrew Clark | Dietitian, Registered | 807 University Pkwy, Box 70403, Johnson City, TN 37614-6500 | 2012-10-16 |
| 1447506795 | Michelle Lanphere Lee | Dietitian, Registered | 807 University Pkwy, Box 70403, Johnson City, TN 37614-1703 | 2012-07-24 |
| 1194070946 | Jon R. Webb | Psychologist | 807 University Pkwy, 139 Lucille Clement Hall, Johnson City, TN 37614-6500 | 2012-07-18 |
| 1073872776 | Etsu Behavioral Health and Wellness Clinic | Community/Behavioral Health | 807 University Pkwy, 139 Lucille Clement Hall, Johnson City, TN 37614-6500 | 2012-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467061887 | Jessica Marie Robinson | Pharmacist | Maple Avenue Building 7, Johnson City, TN 37614 | 2020-07-31 |
| 1881220697 | Rachel Miller Slough | Psychologist | 801 S Dossett Drive, Johnson City, TN 37614 | 2020-03-13 |
| 1326682493 | Yoshihiro Kojima | Specialist/Technologist | 127 W John Robert Bill Dr, Johnson City, TN 37614 | 2019-11-01 |
| 1205360104 | Charlotte Lynn Alexander | Student in an Organized Health Care Education/Training Program | Department of Obstetrics and Gynecology, 70569, Qcom Building 1, Room 307, Johnson City, TN 37614 | 2017-04-18 |
| 1679006787 | Joel Whipple | Student in an Organized Health Care Education/Training Program | Etsu - Building 1, 2nd Floor, Johnson City, TN 37614 | 2017-04-05 |
| 1497295711 | Charles Faust | Dental Hygienist | 1276 Gilbreath Dr, Johnson City, TN 37614 | 2017-03-06 |
| 1265889414 | Dyan Darang | Student in an Organized Health Care Education/Training Program | Etsu, Quillen College of Medicine, Psychiatry Residency Program, Box 70567, Johnson City, TN 37614 | 2016-05-18 |
| 1194170142 | Katharine Ann Lasher | Student in an Organized Health Care Education/Training Program | Dept. of Surgery, Dogwood Ave, Building 1, Rm 249, East Tennessee State Univ. Quillen College of Medicine, Johnson City, TN 37614 | 2016-04-27 |
| 1992150189 | Nishika Shina Moradia | Student in an Organized Health Care Education/Training Program | East Tennessee State University Quillen College of Medi, Dogwood Ave, Building 1, Room 249, Johnson City, TN 37614 | 2016-04-26 |
| 1962884429 | Apurva Bansal | Student in an Organized Health Care Education/Training Program | 325 North State of Franklin, Johnson City, TN 37614 | 2015-06-22 |
| Find all providers in zip 37614 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881220697 | Rachel Miller Slough | Psychologist | 801 S Dossett Drive, Johnson City, TN 37614 | 2020-03-13 |
| 1548692692 | Jason Lee Steadman | Psychologist | 1193 Jack Vest Dr, Behavioral Health and Wellness Clinic, Johnson City, TN 37614-6505 | 2013-07-31 |
| 1649345208 | Matthew David Johnson | Psychologist | 240 Riverside Dr Ste 2, Johnson City, NY 13790-2732 | 2006-11-21 |
| 1588670210 | Stephen L. Owens | Psychologist | 302 Sunset Dr Ste 106, Johnson City, TN 37604-2408 | 2006-08-01 |
| 1467476150 | Tedd A Stephens | Psychologist | 2112 N Roan St Fl 6, Johnson City, TN 37601-2519 | 2006-07-26 |
| 1790717411 | Nancy L Lanthorn | Psychologist | 704 E Watauga Ave, Johnson City, TN 37601-4112 | 2006-07-06 |
| 1811960644 | Kerry L. Holland | Psychologist | 807 University Pkwy, 139 Lucille Clement Hall, Johnson City, TN 37614-6500 | 2006-02-10 |
| 1760464937 | Heather L Beaudry | Psychologist | 1907 N Roan St Ste 207, Johnson City, TN 37601-3182 | 2005-11-15 |
| 1770197766 | Mary Ann Moore | Psychologist | 679 Main St, Johnson City, NY 13790-1716 | 2020-09-07 |
| 1184232605 | Bess Summerlin Lewis | Psychologist | Lamont St & Veterans Way, Johnson City, TN 37604 | 2020-07-21 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37614 |
Please comment or provide details below to improve the information on DR. PEGGY JOYCE CANTRELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.