CASEY UNDERHILL (NPI# 1578925202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578925202 |
| Entity Type | Individual |
| Full Name | CASEY UNDERHILL |
| Credential | MD |
| Practice Address |
5722 Integrity Dr Bldg S771 Millington TN 38054-5028 |
| Practice Telephone | 9018746100 |
| Mailing Telephone | 9018746100 |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2019-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | 01078831A | IN | Allopathic & Osteopathic Physicians |
| Y | 171000000X | Military Health Care Provider | 01078831A | IN | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | STATE LICENSE | 01078821A | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 550 S Jackson St, Louisville, KY 40202 | 7063385183 |
| Street Address |
5722 INTEGRITY DR BLDG S771 |
| City | MILLINGTON |
| State | TN |
| Zip Code | 38054-5028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154757151 | Brandi Amelia Epperson | Nurse Practitioner | 5722 Integrity Dr Bldg S771, Naval Branch Health Clinic Mid-south, Millington, TN 38054-5028 | 2013-09-23 |
| 1477960698 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 5722 Integrity Dr Bldg S771, Millington, TN 38054-5028 | 2014-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073137758 | Stephanie Nicole Zuckerman | Psychologist | Intrepid Street, Bldg. S-771, Millington, TN 38054 | 2020-05-29 |
| 1992243000 | Paul Livernois | Pharmacist | S-752 Tarawa Ave, Millington, TN 38054 | 2017-02-09 |
| 1962751149 | Megan Nicole Seay Shelton | Dentist | 5722 Integrity Drive Building S-771, Millington, TN 38054 | 2012-09-05 |
| 1710208178 | Michael W Johns | Family Medicine | 5722 Intregrity Dr. Bldg. S771, Branch Medical Clinic Nsa Mid-south, Millington, TN 38054 | 2010-06-18 |
| 1053526996 | Ira N.b. Davis | Optometrist | Nex - Midsouth, Bldg S752, Millington, TN 38054 | 2007-05-14 |
| 1487746236 | Robert Dennis Preston Jr. | Military Health Care Provider | Brach Medical Clinic, Naval Support Activity Mid-south, Millington, TN 38054 | 2006-09-29 |
| 1366486086 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | Nex - Navy Support Activity - Memphis, Bldg. S752, Millington, TN 38054 | 2006-06-15 |
| 1710948245 | James R Luedtke | Technician, Other | 5722 Integrity Drive, Bldg S771, Nbhc, Nsa Mid-south, Millington, TN 38054 | 2006-04-02 |
| 1316915333 | Charles Barry Collier | Military Health Care Provider | Branch Medical Clinic, Nsa Mid South, 5722 Integrity Dr Bldg, Millington, TN 38054 | 2006-03-08 |
| 1154391977 | Jose Calixto De La Pena | Family Medicine | 5722 Intergrity Dr., Blgd S771 (nbhc Midsouth, Millington, TN 38054 | 2006-01-24 |
| Find all providers in zip 38054 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275981144 | Sarah Haviland | Military Health Care Provider | 5722 Integrity Dr # S771, Millington, TN 38054-5028 | 2016-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437705613 | Roots of Wellness, Pllc | Military Health Care Provider | 680 E Meeting St Ste E, Dandridge, TN 37725-5077 | 2019-08-14 |
| 1962746198 | Maxie L Robinson | Military Health Care Provider | 2865 Lyncrest Dr, Nashville, TN 37214-3516 | 2012-11-10 |
| 1871629972 | Wendy Michelle Burris | Military Health Care Provider | 556 White Rd, Wartrace, TN 37183-3481 | 2007-02-26 |
| 1295164200 | The Hope Center At Grace | Military Health Care Provider | 982 Meagher St, Memphis, TN 38108-3329 | 2013-11-11 |
| City | MILLINGTON |
| Zip Code | 38054 |
Please comment or provide details below to improve the information on CASEY UNDERHILL.
| 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.