LIFESCAN TENNESSEE, LLC (NPI# 1386832368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386832368 |
| Entity Type | Organization |
| Organization Name | LIFESCAN TENNESSEE, LLC |
| Other Organization Name | MOLECULAR IMAGING ALLIANCE OF TENNESSEE |
| Practice Address |
830 Suncrest Dr Unit 2 Gray TN 37615-3424 |
| Mailing Address |
701 N State of Franklin Rd Suite 1 Johnson City TN 37604-3645 |
| Practice Telephone | 4234773026 |
| Practice Fax Number | 4234772686 |
| Mailing Telephone | 4234773026 |
| Mailing Fax Number | 4234772686 |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2013-09-20 |
| Authorized Official Name | MR. ROBERT GREGORY (PRESIDENT) |
| Authorized Official Telephone | 4234773026 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
ODC0000000042 | TN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3790000 | 05 |
| Other Name | Type Code |
|---|---|
| Molecular Imaging Alliance of Tennessee | Doing Business As Name - Organization |
| Street Address |
830 SUNCREST DR UNIT 2 |
| City | GRAY |
| State | TN |
| Zip Code | 37615-3424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568962983 | Clayton Kilgore | Pharmacist | 208 Suncrest St Unit 1, Gray, TN 37615 | 2018-02-13 |
| 1346648268 | Jesse Mullins | Pharmacist | 121 Boone Ridge Dr, Suite 1006, Johnson City, TN 37615 | 2014-12-09 |
| 1750650875 | Medical Education Assistance Corporation | Pediatrics | 252 Sam Jenkins Rd, Attn: Dr. H. Patrick Stern, Gray, TN 37615 | 2011-12-19 |
| 1700018603 | Anna Lynne Deal | Nurse Practitioner | 119 Boone Ridge Dr., Ste. 201, Johnson City, TN 37615 | 2009-08-11 |
| 1285876631 | Leigh A Furman | Occupational Therapist | 253 Wiltshire Dr., Gray, TN 37615 | 2009-04-01 |
| 1811098908 | Fay Lynn Bembry | Nurse Practitioner | 119 Boone Ridge Drive Ste. 201, Johnson City, TN 37615 | 2006-09-25 |
| 1871528976 | Boones Creek Medical Pllc | Family Medicine | 2685 Boones Creek Road, Suite 104, Johnson City, TN 37615 | 2006-07-11 |
| 1568402048 | Joseph Vincent Pinyard Jr. | Family Medicine | 880 Boones Station Rd, Johnson City, TN 37615 | 2006-06-07 |
| 1548223084 | Pitchar Theerathorn | Internal Medicine | 119 Boone Ridge Drive, Suite 201, Johnson City, TN 37615 | 2006-04-07 |
| 1194717157 | Susan Kay Pennypacker | Nurse Practitioner | 140 Old Gray Station Rd, Suite 200, Gray, TN 37615 | 2005-08-16 |
| Find all providers in zip 37615 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053877373 | Choice Imaging LLC | Clinic/Center | 220 Veterans Pkwy Ste E, Murfreesboro, TN 37128-6436 | 2019-02-11 |
| 1932686318 | Middle Tennessee Imaging, LLC | Clinic/Center | 5700 Temple Rd Ste 102, Nashville, TN 37221-4171 | 2018-07-27 |
| 1972025989 | Middle Tennessee Imaging, LLC | Clinic/Center | 6130 Nolensville Rd Ste 102, Nashville, TN 37211-6813 | 2017-07-11 |
| 1316305089 | Middle Tennessee Imaging, LLC | Clinic/Center | 3754 Murfreesboro Pike Ste 102, Antioch, TN 37013-3878 | 2016-02-09 |
| 1831434687 | Rhc Imaging Center | Clinic/Center | 6590 Summer Knoll Cv, Suite 102, Bartlett, TN 38134-2885 | 2012-12-05 |
| 1043470933 | Vascular and Interventional Radiology Clinic of Jackson | Clinic/Center | 300 Coatsland Dr, Jackson, TN 38301-3908 | 2008-06-13 |
| 1225259518 | C and D Associates | Clinic/Center | 795 Ridge Lake Blvd Ste 107, Memphis, TN 38120-9475 | 2007-05-02 |
| 1528193943 | Bristol Imaging Center, LLC. | Clinic/Center | 1230 Volunteer Pkwy, Bristol, TN 37620-4628 | 2007-02-23 |
| 1518034743 | Elite Ultrasound Imaging, LLC | Clinic/Center | 1033 East Old Hickory Blvd, Madison, TN 37115 | 2006-11-30 |
| 1255358925 | Diagnostic Outpatient Center, Inc. | Clinic/Center | 428 E Bell St, Murfreesboro, TN 37130-2408 | 2006-07-17 |
| 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.