PLASTIC AND RECONSTRUCTIVE SURGERY PC (NPI# 1215167580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215167580 |
| Entity Type | Organization |
| Organization Name | PLASTIC AND RECONSTRUCTIVE SURGERY PC |
| Practice Address |
1303 Sunset Dr Ste 5 Johnson City TN 37604-7905 |
| Practice Telephone | 4233289000 |
| Practice Fax Number | 4233289007 |
| Mailing Telephone | 4233289000 |
| Mailing Fax Number | 4233289007 |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2019-11-13 |
| Authorized Official Name | LAURIE P WEBB (INSURANCE MANAGER) |
| Authorized Official Telephone | 4233289000 |
| Authorized Official Credential | DELEGATED OFFICI |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 173000000X | Legal Medicine | MD0000025117 | TN | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3081165 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 110 Corporate Dr, Suite 100, Johnson City, TN 376042008 | 4232830323 | 4239522696 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851411490 | Plastic and Reconstructive Surgery PC | Plastic Surgery | 1433 Stovall St, Augusta, GA 30904-4883 | 2007-03-29 |
| Street Address |
1303 SUNSET DR STE 5 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-7905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560707 | Brant Logan Nickens | Physical Therapist | 809 Lamont St and Veterans Way, Johnson City, TN 37604 | 2020-08-26 |
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| Find all providers in zip 37604 | ||||
| Taxonomy Code | 173000000X |
| Grouping | Other Service Providers |
| Classification | Legal Medicine |
| The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407065709 | Lee Grimm, Md PC | Legal Medicine | 3101 Browns Mill Rd Pmb 386, Suite 6, Johnson City, TN 37604-4100 | 2007-05-22 |
| 1114136546 | Joseph E. Bieberly, Md | Legal Medicine | 3101 Browns Mill Rd Pmb 386, Suite 6, Johnson City, TN 37604-4100 | 2007-05-22 |
| 1114136561 | Allen Allied Healthcare Inc. | Legal Medicine | 403 Princeton Rd, # 1, Johnson City, TN 37601-2056 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811300791 | Solutions of Savannah | Legal Medicine | 85 Harrison St, Savannah, TN 38372-2280 | 2014-06-09 |
| 1750524138 | Michael H. Meadors | Legal Medicine | 2011 Church St Ste 601, Nashville, TN 37203-2070 | 2009-04-14 |
| 1992940761 | Pediatric Consultants of Lenoir City | Legal Medicine | 303 Medical Park Drive, Lenoir City, TN 37772-6473 | 2008-12-09 |
| 1801046479 | Joseph L. Bowers, Md PC | Legal Medicine | 8489 E Brainerd Rd, Chattanooga, TN 37421-4361 | 2008-09-19 |
| 1265695076 | East West Family Care, PC | Legal Medicine | 1001 Capital Funds Court, Nashville, TN 37217-3937 | 2008-07-02 |
| 1043497555 | Jackson County Medical Center LLC | Legal Medicine | 603 S Murray St, Gainesboro, TN 38562-9376 | 2008-01-28 |
| 1174668230 | Roy P Johnson | Legal Medicine | 936 Murfreesboro Rd, Lebanon, TN 37090-5350 | 2007-02-20 |
| 1336236322 | Robert E Finelli | Legal Medicine | 110 Perimeter Park Rd Ste C, Knoxville, TN 37922-2200 | 2006-10-09 |
| 1083711535 | Jaime Montoya Chavez | Legal Medicine | Box 291, Brownsville, TN 38012 | 2006-09-19 |
| 1760593511 | Tahnya Dunn See | Legal Medicine | 739 President Pl Ste 140, Smyrna, TN 37167-6845 | 2006-08-31 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
Please comment or provide details below to improve the information on PLASTIC AND RECONSTRUCTIVE SURGERY PC.
| 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.