FREDERICK C HARTLEY (NPI# 1760487946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760487946 |
| Entity Type | Individual |
| Full Name | FREDERICK C HARTLEY |
| Credential | M.D. |
| Practice Address |
203 E Watauga Ave Johnson City TN 37601-4629 |
| Practice Telephone | 4239262129 |
| Practice Fax Number | 4239268576 |
| Mailing Telephone | 4239262129 |
| Mailing Fax Number | 4239268576 |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 11190 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3173953 | 05 |
| Street Address |
203 E WATAUGA AVE |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37601-4629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023129376 | Mountain States Health Alliance | General Acute Care Hospital | 203 E Watauga Ave, Johnson City, TN 37601-4629 | 2006-08-31 |
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669615605 | Greater Binghamton Obstetrics and Gynecology,pllc | Obstetrics & Gynecology | 365 Harry L Dr, Suite 110, Johnson City, NY 13790-1471 | 2009-04-07 |
| 1619044765 | Melinda B Rupp | Obstetrics & Gynecology | 180 Harry L Drive, Optional, Johnson City, NY 13790-1566 | 2006-11-30 |
| 1568423028 | Carol Miller | Obstetrics & Gynecology | 401 Main St Ste 1, Johnson City, NY 13790-2065 | 2006-03-31 |
| 1821058660 | Bai O Lee | Obstetrics & Gynecology | 41 Arch St, Johnson City, NY 13790-2101 | 2006-03-24 |
| 1619960713 | Ann Maria Gebka Rouse | Obstetrics & Gynecology | 325 N State of Franklin Rd Fl 1, Johnson City, TN 37604-6056 | 2005-08-24 |
| 1669472932 | Jerome Rosenstein | Obstetrics & Gynecology | 30 Harrison Street, Suite 320, Johnson City, NY 13790-2544 | 2005-07-28 |
| 1518504281 | Women2women Obstetrics and Gynecology, LLC | Obstetrics & Gynecology | 180 Harry L Dr, Johnson City, NY 13790-1566 | 2019-12-02 |
| 1174979926 | Blake T Rozycki | Obstetrics & Gynecology | 301 Med Tech Pkwy Ste 200, Johnson City, TN 37604-2641 | 2016-05-11 |
| 1083079198 | Womens Obgyn PC | Obstetrics & Gynecology | 401 Main St, 1st Flr., Johnson City, NY 13790-2064 | 2015-12-17 |
| 1891107173 | Miranda M Blevins | Obstetrics & Gynecology | 301 Med Tech Pkwy Ste 200, Johnson City, TN 37604-2641 | 2014-05-21 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37601 |
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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.