EAST TENNESSEE UROLOGIC ASSOCIATES (NPI# 1710936257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710936257 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE UROLOGIC ASSOCIATES |
| Practice Address |
508 Princeton Rd Suite 104 Johnson City TN 37601-2060 |
| Practice Telephone | 4239280168 |
| Practice Fax Number | 4239285141 |
| Mailing Telephone | 4239280168 |
| Mailing Fax Number | 4239285141 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. KAY D JONES (OFFICE MANAGER) |
| Authorized Official Telephone | 4239280168 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | RAILROAD MEDICARE | CF2875 | 01 |
| TN | 3382693 | 05 |
| Street Address |
508 PRINCETON RD SUITE 104 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37601-2060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295736569 | Carl W Eilers Jr. | Dentist | 508 Princeton Rd, Suite 204, Johnson City, TN 37601-2060 | 2005-08-09 |
| 1215469358 | Qc Family Practice | Clinic/Center | 508 Princeton Rd, Suite 104, Johnson City, TN 37601-2060 | 2017-03-29 |
| 1942651120 | Angela Dawn Tolley | Psychologist | 508 Princeton Rd, Suite 403, Johnson City, TN 37601-2060 | 2016-06-28 |
| 1538519491 | Marsha Litton-baker | Counselor | 508 Princeton Rd, Ste 403, Johnson City, TN 37601-2060 | 2016-06-21 |
| 1154779817 | Blue Ridge Medical Management Corporation | Psychiatry & Neurology | 508 Princeton Rd, Ste 403, Johnson City, TN 37601-2060 | 2016-06-02 |
| 1497085435 | Daniel Mcclaskey Auter | Dentist | 508 Princeton Rd, Suite 305, Johnson City, TN 37601-2060 | 2010-01-13 |
| 1609045806 | Connie R. Simpson | Counselor | 508 Princeton Rd, Suite 403, Johnson City, TN 37601-2060 | 2008-02-21 |
| 1982808424 | Elizabeth Forgey Cannon | Dentist | 508 Princeton Rd, Suite 303, Johnson City, TN 37601-2060 | 2007-06-11 |
| 1619187283 | Quinton W Carroll | Registered Nurse | 508 Princeton Rd, Suite 104, Johnson City, TN 37601-2060 | 2007-05-23 |
| 1467568360 | Jimmy Dale Westmoreland II | Dentist | 508 Princeton Rd, Johnson City, TN 37601 | 2006-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396381992 | Juan Carlos Simon Villegas Gomez | Specialist/Technologist | 1081 John Robert Bell Dr, Johnson City, TN 37601 | 2019-11-19 |
| 1629537279 | Jaima Suzanne Price | Hearing Instrument Specialist | 106 E Watauga Avenue, Johnson City, TN 37601 | 2019-03-13 |
| 1275004467 | Brittany Howell | Speech-Language Pathologist | 2114 E. Fairview Ave, Johnson City, TN 37601 | 2018-12-16 |
| 1194229948 | Heather Chantel Lester | Physical Therapist | 2114 E. Fairview Avenue, Johnson City, TN 37601 | 2018-03-19 |
| 1477061869 | Patrick Conway Reynolds | Specialist/Technologist | 1081 John Robert Bell Drive, Johnson City, TN 37601 | 2018-01-19 |
| 1790201135 | Surgical Services of East Tennessee PC | Surgery | 300 East Main St., Suite 301, Johnson City, TN 37601 | 2017-08-17 |
| 1073065694 | Davina Leah Reppond | Home Health | 1204 E Myrtle Ave, Johnsoncity, TN 37601 | 2016-10-31 |
| 1003365503 | Wendi Y Minutolo | Behavioral Analyst | 403 Princeton Rd Ste 3, Johnson City, TN 37601 | 2016-09-25 |
| 1306208798 | Rachel Anne Anderson | Nurse Practitioner | 1118 East Holston Avenue, Johnson City, TN 37601 | 2016-03-24 |
| 1932560976 | Kaydee Louise Davidson | Occupational Therapist | 3209 Bristol Highway, Johnson City, TN 37601 | 2016-03-18 |
| Find all providers in zip 37601 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962443226 | James Marion Wilson | Urology | James Quillen Medical Center, Moutain Home Va, Johnson City, TN 37684 | 2006-06-09 |
| 1609830504 | Wayne P Tongco | Urology | 2340 Knob Creek Rd, Suite 720, Johnson City, TN 37604-2100 | 2006-04-17 |
| 1043463029 | William Bradley Rogers | Urology | 2340 Knob Creek Rd, Suite 720, Johnson City, TN 37604-2977 | 2008-11-04 |
| 1801920061 | Lincoln Todd Olsen | Urology | 2340 Knob Creek Rd, Suite 720, Johnson City, TN 37604-2100 | 2007-03-16 |
| 1144317181 | John Mark Kolski | Urology | James H. Quillen/vamc, Corner of Sidney and Lamont, Johnson City, TN 37684 | 2006-10-10 |
| 1952310815 | Natwar Kumar Pareek | Urology | 30 Harrison St, Suite 460, Johnson City, NY 13790-2161 | 2006-08-07 |
| 1932159472 | David W Jones | Urology | 508 Princeton Rd, Suite 104, Johnson City, TN 37601-2060 | 2006-05-12 |
| 1306895727 | Bill N Boswell | Urology | 508 Princeton Rd, Suite 104, Johnson City, TN 37601-2060 | 2006-05-10 |
| 1427013044 | Grant D Taylor | Urology | 2340 Knob Creek Rd, Suite 720, Johnson City, TN 37604-2100 | 2006-04-18 |
| 1467417089 | Thomas B Mcginnis | Urology | 300 W Watauga Ave, Johnson City, TN 37604-5549 | 2006-04-18 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37601 |
Please comment or provide details below to improve the information on EAST TENNESSEE UROLOGIC ASSOCIATES.
| 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.