DR. MARY ANNE KNACK (NPI# 1497862411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497862411 |
| Entity Type | Individual |
| Full Name | DR. MARY ANNE KNACK |
| Credential | PH.D. |
| Practice Address |
1030 Jefferson Ave 116a4 Memphis TN 38104-2127 |
| Mailing Address |
6470 Belmont Cv Memphis TN 38135-9492 |
| Practice Telephone | 9015238990 |
| Mailing Telephone | 9013778684 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103TC1900X |
Psychologist Specialization: Counseling |
P0000001933 | TN | Behavioral Health & Social Service Providers |
| X | 103TH0100X |
Psychologist Specialization: Health Service |
P0000001933 | TN | Behavioral Health & Social Service Providers |
| Street Address |
1030 JEFFERSON AVE 116A4 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38104-2127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982697025 | Katherine Denton Sanford | Optometrist | 1030 Jefferson Ave, Mail Code 112d, Memphis, TN 38104-2127 | 2005-08-24 |
| 1528667938 | Mckenzie Bahl | Recreation Therapist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-10-19 |
| 1427656834 | Phillip David Resuggan | Music Therapist | 1030 Jefferson Ave, Memphis, TN 38104-2193 | 2020-10-16 |
| 1962009159 | Rachel Diann Roberts | Nurse Anesthetist, Certified Registered | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-10-01 |
| 1225643018 | Melanie Warren | Nurse Practitioner | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-09-09 |
| 1942828892 | Brady Cole | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-07-08 |
| 1457978595 | Mariko Thel | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-07-05 |
| 1215554910 | Weston Paul Keen | Pharmacy | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-29 |
| 1225655236 | Rebecca Fong | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-26 |
| 1225653660 | Brandy Hollums | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900367 | Christy White | Recreation Therapist | 1030 Jefferson Ave (rt117), Memphis, TN 38104 | 2020-10-19 |
| 1821615873 | Altiana Carter | Optometrist | 650 New York St, Memphis, Tn 38104, Memphis, TN 38104 | 2020-06-25 |
| 1952898413 | Family To Family Adult Care Service | Chore Provider | 1331 Union Ave Suite 1028, Mempnis, TN 38104 | 2018-04-19 |
| 1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
| 1649799339 | Benjamin Duhart Jr. | Pharmacist | 1265 Union Avenue- Methodist University Hospital, Ground Floor Pharmacy Administration, Memphis, TN 38104 | 2017-09-13 |
| 1134644982 | Amy Michelle Wise | Nurse Practitioner | 1325 Eastmoreland Ave Ste 500, Memphis, TN 38104 | 2017-08-13 |
| 1316468572 | Jinger Cathey | Social Worker | 1330 Jefferson Ave, Memphis, TN 38104 | 2017-06-28 |
| 1336669183 | Charma May Kavuncu | Social Worker | 1407 Union Ave Ste 1100, Memphis, TN 38104 | 2017-06-22 |
| 1003345398 | Angelica J Dennis | Nurse Practitioner | 1265 Union, Memphis, TN 38104 | 2017-06-08 |
| 1609302546 | Cheryl Beene | Nurse Practitioner | 1211 Union Ave Ste 475, Memphis, TN 38104 | 2017-05-11 |
| Find all providers in zip 38104 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427603554 | University of Memphis | Psychologist | 4055 North Park Loop, Suite 1000, Memphis, TN 38152 | 2019-08-06 |
| 1396953071 | Robert Joseph Maichrowicz | Psychologist | 214 Wilder Tower, University of Memphis, Memphis, TN 38152-0001 | 2007-05-18 |
| 1356489827 | Gina L Prigoff | Psychologist | 740 E Brookhaven Cir, Suite 5, Memphis, TN 38117-4547 | 2007-02-04 |
| 1326110586 | Sharon Smith Thompson | Psychologist | 35 S Auburndale St, Memphis, TN 38104-3916 | 2006-11-14 |
| 1811008113 | Leanne Pate | Psychologist | 4646 Poplar Avenue, #326, Memphis, TN 38117-4442 | 2006-08-31 |
| 1417992298 | Clifford Rambo Heegel | Psychologist | 4728 Spottswood Ave, #361, Memphis, TN 38117-4817 | 2006-06-17 |
| 1558359463 | William Fleming Mealer | Psychologist | 1037 Cresthaven Rd, Memphis, TN 38119-3833 | 2005-10-13 |
| 1437795671 | Katherine Brown | Psychologist | 815 Mount Moriah Rd, Memphis, TN 38117-5704 | 2019-11-22 |
| 1841696101 | Wright Enhancement Center | Psychologist | 3311 Kimball Ave, Memphis, TN 38111-3846 | 2014-11-14 |
| 1174965024 | Shakira S Thomas | Psychologist | 8295 Tournament Dr, Memphis, TN 38125-8906 | 2013-07-20 |
| Find all providers in MEMPHIS | ||||
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| 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.