JOHNSON CITY UROLOGICAL CLINIC, P.C. (NPI# 1578689253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578689253 |
| Entity Type | Organization |
| Organization Name | JOHNSON CITY UROLOGICAL CLINIC, P.C. |
| Practice Address |
2340 Knob Creek Road Suite 720 Johnson City TN 37604-2977 |
| Practice Telephone | 4239266112 |
| Practice Fax Number | 4234340278 |
| Mailing Telephone | 4239266112 |
| Mailing Fax Number | 4234340278 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2009-08-19 |
| Authorized Official Name | GRANT D TAYLOR (OWNER) |
| Authorized Official Telephone | 4239266112 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2088P0231X |
Urology Specialization: Pediatric Urology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3172410 | 05 |
| Street Address |
2340 KNOB CREEK ROAD SUITE 720 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-2977 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063719862 | Bethany B Thomas | Speech-Language Pathologist | 2340 Knob Creek Road, Suite 704, Johnson City, TN 37604 | 2011-02-15 |
| 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 | 2088P0231X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Pediatric Urology |
| Surgeons who can diagnose, treat, and manage children’s urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). |
| Notes: Source: American Academy of Pediatrics [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568958775 | Blue Ridge Medical Management Corporation | Urology | 408 N State of Franklin Rd Ste 31f, Johnson City, TN 37604-6088 | 2018-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750449484 | Herbert Victor Braren | Urology | 329 Twenty-first Av N, Suite 2, Nashville, TN 37203-1855 | 2006-12-05 |
| 1306849849 | Daniel B Herz | Urology | 979 E 3rd St, Suite C-925, Chattanooga, TN 37403-2136 | 2005-05-28 |
| 1124378484 | Nashville Pediatric Urology, PC | Urology | 330 23rd Ave N, Suite 602, Nashville, TN 37203-1534 | 2012-09-14 |
| 1649536350 | Mary Elaine Killian | Urology | 51 N Dunlap St, Memphis, TN 38105-4625 | 2012-04-06 |
| 1417252594 | Mid-state Urology PC | Urology | 329 21st Ave N, Suite 2, Nashville, TN 37203-1839 | 2011-01-20 |
| 1609192905 | Rhys Wingart Irvine | Urology | 2100 Clinch Ave Ste 130, Knoxville, TN 37916-2224 | 2010-04-12 |
| 1760669808 | Joseph Murphy Gleason | Urology | 51 N Dunlap St, Suite 100, Memphis, TN 38105-4625 | 2008-01-30 |
| City | JOHNSON CITY |
| Zip Code | 37604 |
Please comment or provide details below to improve the information on JOHNSON CITY UROLOGICAL CLINIC, P.C..
| 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.