JERRY L GASTINEAU (NPI# 1124118971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124118971 |
| Entity Type | Individual |
| Full Name | JERRY L GASTINEAU |
| Practice Address |
1505 W Elk Ave Suite 2 Elizabethton TN 37643-2848 |
| Practice Telephone | 4235431261 |
| Practice Fax Number | 4235437500 |
| Mailing Telephone | 4235431261 |
| Mailing Fax Number | 4235437500 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2014-12-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 170100000X | Medical Genetics, Ph.D. Medical Genetics | MD7688 | TN | Other Service Providers |
| Y | 207Q00000X | Family Medicine | 7688 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3152032 | 05 | |
| TN | JOHNDEERE | TN0102 | 01 |
| TN | AMERICHOICE | TN0102 | 01 |
| TN | BLUECARE | 201575 | 01 |
| TN | BCBS | 4360576 | 01 |
| TN | 201575 | BLUECROSS | 01 |
| Street Address |
1505 W ELK AVE SUITE 2 |
| City | ELIZABETHTON |
| State | TN |
| Zip Code | 37643-2848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518902378 | First Medical Group Inc. | Health Maintenance Organization | 1505 W Elk Ave, Ste 2, Elizabethton, TN 37643-2848 | 2006-06-17 |
| 1457693996 | Blue Ridge Medical Management Corporation | Internal Medicine | 1505 W Elk Ave, Suite 2, Elizabethton, TN 37643-2848 | 2013-03-22 |
| 1467691857 | Rebecca P Wilkins | Nurse Practitioner | 1505 W Elk Ave, Elizabethton, TN 37643-2848 | 2009-02-09 |
| 1710140249 | Ryan Andrew Hackett | Family Medicine | 1505 W Elk Ave, Suite 2, Elizabethton, TN 37643-2848 | 2008-07-03 |
| 1801080171 | Rebekah Livingston Swink | Family Medicine | 1505 W Elk Ave, Suite 2, Elizabethton, TN 37643-2848 | 2007-08-30 |
| 1780774570 | Robert Edmund Walter | Medical Genetics, Ph.D. Medical Genetics | 1505 W Elk Ave, Suite 2, Elizabethton, TN 37643-2848 | 2006-10-13 |
| 1124119458 | David Kenneth Fenner | Medical Genetics, Ph.D. Medical Genetics | 1505 W Elk Ave, Suite 2, Elizabethton, TN 37643-2848 | 2006-09-28 |
| 1699867861 | Christopher Manoli Chrisohon | Medical Genetics, Ph.D. Medical Genetics | 1505 W Elk Ave, Suite 2, Elizabethton, TN 37643-2848 | 2006-09-28 |
| 1700983210 | First Medical Group Inc | Obstetrics & Gynecology | 1505 W Elk Ave, Suite 1, Elizabethton, TN 37643-2848 | 2006-09-19 |
| 1659486900 | John David Green | Obstetrics & Gynecology | 1505 W Elk Ave, Suite 1, Elizabethton, TN 37643-2848 | 2006-08-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558831115 | Blue Ridge Medical Management Corporation | Internal Medicine | 404 Bemberg Rd, Elizabethton, TN 37643 | 2018-11-27 |
| 1396269072 | Solutions Medical Centers Pllc | General Practice | Solutions Medical Centers, 851 W Elk Ave, Elizabethton, TN 37643 | 2017-08-03 |
| 1437533924 | Dr. Benjamin D. Parrish and Assoc Od. PC | Optometrist | 114 S. Sycamore St, Elizabethton, TN 37643 | 2015-07-14 |
| 1972980431 | Valerie Lynn Pierce | Nurse's Aide | 101 Crowe Rd, Elizabethton, TN 37643 | 2015-05-04 |
| 1679816730 | Jeremy Meyer | Surgery | 1497 W Elk Ave Ste 10, Elizabethton, TN 37643 | 2013-03-27 |
| 1649579087 | Melinda Lynn Jennings | Pharmacist | 507 West Elk Ave, Elizbethton, TN 37643 | 2011-03-24 |
| 1588987036 | Troy Kevin Covarrubias | Driver | 219 Coal Chute Rd, Elizabethton, TN 37643 | 2010-03-11 |
| 1649502048 | Derek Charles Rhoton | Physician Assistant | 1500 West Elk Ave, Elizabethton, TN 37643 | 2010-02-10 |
| 1144456047 | Peacock Medical Equipment and Home Health Care LLC | Home Health | 1201 Highway 19 E Bypass Suite 3, Elizabethton, TN 37643 | 2009-06-05 |
| 1235386434 | Bio-medical Applications of Tennessee, Inc. | Clinic/Center | 1210 Militia Ct., Elizabethton, TN 37643 | 2008-08-19 |
| Find all providers in zip 37643 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821449216 | Sabaina Arshad | Family Medicine | 1505 W Elk Ave Ste 2, Elizabethton, TN 37643-2848 | 2016-06-27 |
| 1699863340 | Daniel Joseph Paul | Family Medicine | 145 Judge Don Lewis Blvd Ste 7, Elizabethton, TN 37643-6007 | 2006-10-10 |
| 1588693691 | Blue Ridge Medical Management Corporation | Family Medicine | 305 Lawson Ave, Elizabethton, TN 37643-2926 | 2006-07-01 |
| 1477525699 | Buddy J Clayton | Family Medicine | 1497 W Elk Ave, Suite 11, Elizabethton, TN 37643-2895 | 2006-02-02 |
| 1043282213 | Donald Frederick Thompson | Family Medicine | 314 Rogosin Dr, Elizabethton, TN 37643-2904 | 2006-02-02 |
| 1255331740 | Kenneth M Hopland | Family Medicine | 1500 W Elk Ave, Elizabethton, TN 37643-2654 | 2005-07-26 |
| 1275530560 | Aly A. Bassal | Family Medicine | 1000 W G St, Suite 104, Elizabethton, TN 37643-2959 | 2005-07-01 |
| 1134653231 | Julieanne Davis | Family Medicine | 1500 W Elk Ave, Elizabethton, TN 37643-2654 | 2017-04-14 |
| 1205377876 | Amanda R Lingerfelt | Family Medicine | 314 Rogosin Dr, Elizabethton, TN 37643-2904 | 2017-03-16 |
| 1629432828 | Blue Ridge Medical Management Corporation | Family Medicine | 1497 W Elk Ave, Suite 20, Elizabethton, TN 37643-2895 | 2016-04-13 |
| Find all providers in ELIZABETHTON | ||||
| City | ELIZABETHTON |
| Zip Code | 37643 |
Please comment or provide details below to improve the information on JERRY L GASTINEAU.
| 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.