EAST TENNESSEE AMBULATORY SURGERY CENTER LLC (NPI# 1659360071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659360071 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE AMBULATORY SURGERY CENTER LLC |
| Practice Address |
701 Med Tech Pkwy Johnson City TN 37604-2259 |
| Practice Telephone | 4232837302 |
| Practice Fax Number | 4232823670 |
| Mailing Telephone | 4232837302 |
| Mailing Fax Number | 4232823670 |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | JIM N BRANTNER (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4232837302 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
0000000109 | TN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BCBS TENNCARE | 3135707 | 01 |
| BCBS OF TN | 3135707 | 01 | |
| UMWA | 145422 | 01 | |
| TN | 3288092 | 05 | |
| AETNA | 0007447071 | 01 |
| Street Address |
701 MED TECH PKWY |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-2259 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902319585 | Josh Partin | Physician Assistant | 701 Med Tech Pkwy, Johnson City, TN 37604-2365 | 2017-11-06 |
| 1275959306 | Holly Whitt | Physical Therapist | 701 Med Tech Pkwy, Suite 301, Johnson City, TN 37604-2365 | 2014-03-13 |
| 1528482924 | Erin Douglas | Physician Assistant | 701 Med Tech Pkwy, Suite 300, Johnson City, TN 37604-2365 | 2014-02-06 |
| 1083046791 | Amber Preston Butler | Nurse Practitioner | 701 Med Tech Pkwy, Suite 300, Johnson City, TN 37604-2365 | 2013-08-05 |
| 1013257526 | Alliance Anesthesia Pllc | Nurse Anesthetist, Certified Registered | 701 Med Tech Pkwy, Suite 300, Johnson City, TN 37604-2365 | 2013-02-20 |
| 1215276654 | Bailey Elizabeth Qualls | Physician Assistant | 701 Med Tech Pkwy, Suite 300, Johnson City, TN 37604-2365 | 2013-02-05 |
| 1780957738 | Richard Christopher Maupin | Physician Assistant | 701 Med Tech Pkwy, Suite 300, Johnson City, TN 37604-2365 | 2012-02-21 |
| 1134427149 | Catherine Moyer | Physical Therapist | 701 Med Tech Pkwy, Suite 301, Johnson City, TN 37604-2365 | 2011-03-01 |
| 1487978631 | Theresa Marie Huff | Physical Therapist | 701 Med Tech Pkwy, Suite 300, Johnson City, TN 37604-2365 | 2010-03-17 |
| 1073848909 | Andrew Morgan | Physical Therapist | 701 Med Tech Pkwy, Suite 301, Johnson City, TN 37604-2365 | 2009-10-09 |
| Find all providers in the same location | ||||
| 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 | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760486369 | Mountain Empire Surgery Center Lp | Clinic/Center | 601 Med Tech Pkwy, Johnson City, TN 37604 | 2005-06-10 |
| 1376886887 | Reeves Eye Surgery Center LLC | Clinic/Center | 2328 Knob Creek Rd, Suite 500, Johnson City, TN 37604 | 2013-04-03 |
| 1942317672 | Tri-cities Outpatient Surgery, Inc. | Clinic/Center | 1009 N State of Franklin Access Road, Suite B, Johnson City, TN 37604 | 2006-08-25 |
| 1720024284 | Pma Surgery Center, LLC | Clinic/Center | 101 Med Tech Pkwy, Suite 205, Johnson City, TN 37604-4007 | 2006-06-22 |
| 1164488219 | Endoscopy Center of Northeast Tennessee, PC | Clinic/Center | 310 N State of Franklin Rd, Suite 202, Johnson City, TN 37604-6008 | 2006-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255939559 | Endoscopy Center of St Thomas Lp | Clinic/Center | 4230 Harding Pike Ste 309b, Nashville, TN 37205-2013 | 2020-10-09 |
| 1790344182 | Bristol Ambulatory Surgery Center, LLC | Clinic/Center | 350 Blountville Hwy Ste 108, Bristol, TN 37620-1676 | 2019-06-10 |
| 1528622321 | Premier-covenant Astc LLC | Clinic/Center | 6408 Papermill Dr Ste 220, Knoxville, TN 37919-4858 | 2019-04-26 |
| 1790348142 | The Plastic Surgery Center Brentwood | Clinic/Center | 620 Church Street East, Brentwood, TN 37027 | 2019-04-20 |
| 1326508045 | Eye Surgery Center of Lenoir City, LLC | Clinic/Center | 5491 Creekwood Park Blvd Ste B, Lenoir City, TN 37772-1204 | 2019-03-20 |
| 1629536826 | Meadowview Asc, LLC | Clinic/Center | 2033 Meadowview Ln Ste 210, Kingsport, TN 37660-7569 | 2019-03-06 |
| 1780157990 | Renaissance Surgery Center, LLC | Clinic/Center | 320 Bristol West Blvd Ste 1a, Bristol, TN 37620-8773 | 2019-01-10 |
| 1619487782 | Uch Vascular Access Asc LLC | Clinic/Center | 6490 Mt Moriah Rd Ext Ste 202, Memphis, TN 38115-3841 | 2017-10-03 |
| 1841712452 | Saint Thomas Surgery Center New Salem, LLC | Clinic/Center | 2755 New Salem Highway, Murfreesboro, TN 37128-3712 | 2017-07-14 |
| 1255860383 | Eye Surgery Center of Knoxville, LLC | Clinic/Center | 7739 Dannaher Drive, Powell, TN 37849 | 2017-06-12 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
Please comment or provide details below to improve the information on EAST TENNESSEE AMBULATORY SURGERY CENTER LLC.
| 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.