MRS. DEBBIE DEBERRY (NPI# 1649792813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649792813 |
| Entity Type | Individual |
| Full Name | MRS. DEBBIE DEBERRY |
| Credential | LSPE |
| Practice Address |
133 Mecklinburg Dr Bolivar TN 38008-1747 |
| Practice Telephone | 7313433084 |
| Mailing Telephone | 7313433084 |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
1482 | TN | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 622 W Market St, Bolivar, TN 380082241 | 7313433084 | 7313433084 |
| Street Address |
133 MECKLINBURG DR |
| City | BOLIVAR |
| State | TN |
| Zip Code | 38008-1747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720639172 | Shanna Shackelford | Nurse Practitioner | 11100 Old Hwy 64 W, Bolivar, TN 38008 | 2019-09-26 |
| 1598326233 | Holly Brooke Shourd | Family Medicine | 1359 W Market St., Bolivar, TN 38008 | 2019-06-24 |
| 1992299234 | Angela Dawn Haynes | Registered Nurse | 10825 Hwy 64w, Bolivar, TN 38008 | 2018-06-20 |
| 1326595919 | Ashley Evon Jowers | Nurse Practitioner | 11100 Old Hwy 64 West, Bolivar, TN 38008 | 2016-09-01 |
| 1942458344 | Anita Pearl Johnson | Physical Therapy Assistant | 700 Knuckolls Ave, Bolivar, TN 38008 | 2008-08-28 |
| 1841340007 | State of Tennessee | Public Health or Welfare | 10825 Old Hwy 64, Bolivar, TN 38008 | 2007-01-11 |
| 1164479721 | Betty Ragon Lenoir | Physical Therapist | 789 Tennessee St, Bolivar, TN 38008 | 2006-05-28 |
| 1689623050 | County of Hardeman | Ambulance | 735 Naylor St, Bolivar, TN 38008 | 2006-05-10 |
| 1841287109 | Michiel Brent Rudder | Family Medicine | 622 West Market Street, Bolivar, TN 38008 | 2005-10-03 |
| 1982606497 | Richard Mast Reinhard IIi | Pediatrics | 629 Nuckolls Rd, Bolivar, TN 38008 | 2005-08-15 |
| Find all providers in zip 38008 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938076 | Ashley Young | Psychologist | 128 Farmbrook Ct, Murfreesboro, TN 37128-2995 | 2020-06-26 |
| 1366061467 | Polly Palmer | Psychologist | 925 Granada Ave, Nashville, TN 37206-3425 | 2020-04-09 |
| 1093362733 | Janita Rhodes | Psychologist | 35 Williamson Rd, Denmark, TN 38391-1828 | 2019-08-19 |
| 1922504901 | Vincent Scott Hooper | Psychologist | 6112 Mont Richer Ave, Knoxville, TN 37918-9314 | 2018-03-30 |
| 1538691605 | Rosemarie Morelan | Psychologist | 128 County Road 801, Etowah, TN 37331-5211 | 2017-03-29 |
| 1649718560 | Tera Bradley | Psychologist | 108 Stirton Rd, Nashville, TN 37210-5120 | 2017-02-11 |
| 1912445834 | Katherine Wilds Price | Psychologist | 643 Blackstone Ave, Madison, TN 37115-4103 | 2017-02-11 |
| 1821461856 | Susan D. Sasse | Psychologist | 614 Georgia Ave, Signal Mountain, TN 37377-1814 | 2015-11-13 |
| 1114358108 | Michelle Fast | Psychologist | 205 Oak Grove Rd, Madisonville, TN 37354-5930 | 2013-12-02 |
| 1518307578 | Anitra Danielle Shelton-quinn | Psychologist | 2930 Airways Blvd, Memphis, TN 38116-3844 | 2013-07-04 |
| Find all providers with the same taxonomy | ||||
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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.