SOUTHEASTERN EMERGENCY SERVICES P C (NPI# 1669414264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669414264 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN EMERGENCY SERVICES P C |
| Practice Address |
1114 W Madison Ave Athens TN 37371 |
| Mailing Address |
P O Box 634760 Cincinnati OH 45263-4760 |
| Practice Telephone | 4237451411 |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2020-09-14 |
| Authorized Official Name | DR. RANDAL L DABBS (PRESIDENT) |
| Authorized Official Telephone | 8656931000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207PP0204X |
Emergency Medicine Specialization: Pediatric Emergency Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | TN | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
TN | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 06310389 | 05 | |
| NC | 2348298 | 05 | |
| AL | 529929400 | 05 | |
| SC | GP4818 | 05 | |
| MO | 507432003 | 05 | |
| KY | 7100010470 | 05 | |
| KY | 78903671 | 05 | |
| MS | 02121280 | 05 | |
| MS | 05515899 | 05 |
| Street Address |
1114 W MADISON AVE |
| City | ATHENS |
| State | TN |
| Zip Code | 37371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144214156 | Kenneth Rand Lamm | Pathology | 1114 W Madison Ave, Athens, TN 37303-4150 | 2005-09-06 |
| 1659998425 | Ryan Matthew Bellomy | Nurse Practitioner | 1114 W Madison Ave, Athens, TN 37303-4150 | 2020-06-28 |
| 1437631967 | Aashna Pandya | Physician Assistant | 1114 W Madison Ave, Athens, TN 37303-4150 | 2018-08-31 |
| 1467901058 | Lori Younce | Nurse Practitioner | 1114 W Madison Ave, Athens, TN 37303-4150 | 2016-09-24 |
| 1710330659 | Andrea R Perkins | Physician Assistant | 1114 W Madison Ave, Athens, TN 37303-4150 | 2016-07-15 |
| 1851776710 | John T Wier | Registered Nurse | 1114 W Madison Ave, Athens, TN 37303-4150 | 2015-07-21 |
| 1578968566 | Heather Woods | Nurse Practitioner | 1114 W Madison Ave, Athens, TN 37303-4150 | 2014-11-03 |
| 1346678430 | Athens Regional Medical Center LLC | Psychiatric Unit | 1114 W Madison Ave, Athens, TN 37303-4150 | 2013-10-29 |
| 1578907010 | Benjamin Wilson Kendrick | Physician Assistant | 1114 W Madison Ave, Athens, TN 37303-4150 | 2013-04-27 |
| 1194030809 | Brandon Wells Watson | Physician Assistant | 1114 W Madison Ave, Athens, TN 37303-4150 | 2010-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891935854 | Janie Gale Holder | Registered Nurse | 393 Showbarn Rd., Athens, TN 37371 | 2009-03-03 |
| 1508071093 | Janice Hughes Crabtree | Registered Nurse | 393 County Road 594, Athens, TN 37371 | 2007-05-10 |
| 1407060197 | Clara Dianne Young | Registered Nurse | Mcminn County Health Department, 393 County Road 554, Athens, TN 37371 | 2007-05-10 |
| 1356418040 | Mary Rose Hilchey | Counselor | 123 Washington Ave, Restoration Counseling, Athens, TN 37371 | 2006-11-29 |
| 1033197074 | Keith L Fisher | Pathology | 1114 West Madison Ave, Athens, TN 37371 | 2006-01-09 |
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881223956 | Lauren Fesperman | Nurse Practitioner | 242 King Ave Ste 130, Athens, GA 30606 | 2020-04-02 |
| 1013576016 | Lauren Gruendling | Nurse Practitioner | 242 King Avenue, Suite 210, Athens, GA 30606 | 2019-06-12 |
| 1861982993 | Sarah Standard Lockwood | Nurse Practitioner | 210 Lexington Cir, Athens, GA 30605-4991 | 2018-05-15 |
| 1447798616 | Kristy Leanne Williams | Nurse Practitioner | 101 Fitness Way Ste 1200, Athens, AL 35611-2492 | 2017-02-07 |
| 1790959708 | Bertha Stauff | Nurse Practitioner | 700 Sunset Drive Suite 504, Athens, GA 30606 | 2008-04-22 |
| 1295906634 | Wendy Lynn Prince | Nurse Practitioner | 725 W Market St Ste B, Athens, AL 35611-2456 | 2008-03-13 |
| 1386868768 | Holly Collier | Nurse Practitioner | 1088 Baxter St Ste A, Athens, GA 30606-6316 | 2007-04-13 |
| 1467552315 | Margaret A. Tonkovich | Nurse Practitioner | 542 W Union St Ste B, Athens, OH 45701-8300 | 2006-09-22 |
| 1073526547 | Benna Ellis Cunningham | Nurse Practitioner | 370 River Road, Athens, GA 30602-1755 | 2006-08-14 |
| 1871502732 | Cynthia Nixon | Nurse Practitioner | 704 S Palestine St, Athens, TX 75751-3325 | 2006-08-07 |
| Find all providers in ATHENS | ||||
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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.