DR. LARRY T JUSTICE (NPI# 1790721819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790721819 |
| Entity Type | Individual |
| Full Name | DR. LARRY T JUSTICE |
| Credential | M.D. |
| Practice Address |
80 Vermont Ave Oak Ridge TN 37830-6474 |
| Practice Telephone | 8654824078 |
| Practice Fax Number | 8654824960 |
| Mailing Telephone | 8654824078 |
| Mailing Fax Number | 8654824960 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2020-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
40574 | TN | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
40574 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q009959 | 05 | |
| TN | 3338151 | 05 | |
| TN | 3379860 | 05 | |
| KYMEDICAID | 7100065540 | 01 | |
| TN | BCBST | 4125100 | 01 |
| Street Address |
80 VERMONT AVE |
| City | OAK RIDGE |
| State | TN |
| Zip Code | 37830-6474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114972098 | Victor W Mclaughlin | Internal Medicine | 80 Vermont Ave, Oak Ridge, TN 37830-6474 | 2006-05-23 |
| 1003474354 | Jessica Lynn Hamby | Nurse Practitioner | 80 Vermont Ave, Oak Ridge, TN 37830-6474 | 2019-06-02 |
| 1588123806 | Tiffani Marie Zichko | Nurse Practitioner | 80 Vermont Ave, Oak Ridge, TN 37830-6474 | 2019-03-16 |
| 1013272962 | Laura A Cutler | Nurse Practitioner | 80 Vermont Ave, Oak Ridge, TN 37830-6474 | 2012-07-06 |
| 1679845713 | Michael V Stewart | Physician Assistant | 80 Vermont Ave, Oak Ridge, TN 37830-6474 | 2012-02-06 |
| 1699933846 | Carlos Antonio Montes | Internal Medicine | 80 Vermont Ave, Oak Ridge, TN 37830-6474 | 2008-05-23 |
| 1659567568 | Stephanie Anne Wilkerson | Nurse Practitioner | 80 Vermont Ave, Oak Ridge, TN 37830-6474 | 2007-09-25 |
| 1396944575 | Saadi Ahmad Siddiqi | Internal Medicine | 80 Vermont Ave, Oak Ridge, TN 37830-6474 | 2007-07-17 |
| 1457362659 | Rakesh Vohra | Internal Medicine | 80 Vermont Ave, Oak Ridge, TN 37830-6474 | 2006-08-11 |
| 1174561971 | James Scott Halama | Internal Medicine | 80 Vermont Ave, Oak Ridge, TN 37830-6474 | 2006-06-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194388702 | Oak Ridge Pharmacy | Pharmacy | 854 Main St W, Oak Ridge, TN 37830 | 2019-04-18 |
| 1134682693 | Mac's Pharmacy Oak Ridge, LLC | Pharmacy | 45 New York Avenue, Oak Ridge, TN 37830 | 2019-04-11 |
| 1689153876 | Tapuwa Martin Chikowore | Dentist | 377 S Illinois Ave, Oak Ridge, TN 37830 | 2018-08-09 |
| 1710475660 | Oak Ridge Smiles Dentistry, PC | Dentist | 377 S. Illinois Ave., Oak Ridge, TN 37830 | 2018-04-26 |
| 1417344763 | Heather Cupp | Social Worker | 723 Emory Valley Road, Oak Ridge, TN 37830 | 2015-04-23 |
| 1366701534 | Quality Care From The Heart | Preferred Provider Organization | 144 Newport Drive, Oak Ridge, TN 37830 | 2012-05-09 |
| 1578838223 | Second Chance Recovery In Faith, Inc | Community/Behavioral Health | 234 W Tennessee Ave, Oak Ridge, TN 37830 | 2012-03-14 |
| 1720364615 | Douglas Miller | Pharmacist | 1299 Oak Ridge Turnpike, Oak Ridge, TN 37830 | 2011-10-24 |
| 1619263852 | Namratha Reddy Vontela | Internal Medicine | 200 New York Ave Ste 200, Oak Ridge, TN 37830 | 2011-06-27 |
| 1356658165 | Fred Lewis Stephens | Social Worker | 150 E Division Rd Ste 10, Oak Ridge, TN 37830 | 2010-09-01 |
| Find all providers in zip 37830 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114972098 | Victor W Mclaughlin | Internal Medicine | 80 Vermont Ave, Oak Ridge, TN 37830-6474 | 2006-05-23 |
| 1770549271 | Frederick James Barry | Internal Medicine | 122 Barrington Dr, Oak Ridge, TN 37830-7669 | 2006-04-24 |
| 1992967244 | Anderson Heart Physicians PC | Internal Medicine | 200 New York Ave, Suite 110, Oak Ridge, TN 37830-5212 | 2008-06-27 |
| 1619198306 | Milan J Sheth | Internal Medicine | 80 Vermont Ave., Oak Ridge, TN 37830 | 2007-05-01 |
| 1174561971 | James Scott Halama | Internal Medicine | 80 Vermont Ave, Oak Ridge, TN 37830-6474 | 2006-06-03 |
| 1376590315 | Parkway Cardiology Associates P C | Internal Medicine | 80 Vermont Ave, Oak Ridge, TN 37830-6474 | 2006-05-27 |
| 1205881240 | James R Michel | Internal Medicine | 80 Vermont Ave, Oak Ridge, TN 37830-6474 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935437 | Cvc Pllc | Internal Medicine | 22 Deepwood Dr, Jackson, TN 38305-9679 | 2020-06-02 |
| 1073085189 | Heart Center Usa Incorporated | Internal Medicine | 6500 Kirby Gate Blvd, Memphis, TN 38119-2673 | 2018-12-31 |
| 1700357035 | Morristown Heart, Pllc | Internal Medicine | Morristown Heart, Pllc, 735 Mcfarland Street, Morristown, TN 37814 | 2018-12-16 |
| 1902353444 | Hh Physician Care-elkton Tennessee | Internal Medicine | 1446 Bryson Road, Ardmore, TN 38449 | 2016-09-01 |
| 1902352750 | Rose Marie Robertson | Internal Medicine | 4003 Newman Pl, Nashville, TN 37204-4308 | 2016-08-31 |
| 1013374073 | Amg Crockett LLC | Internal Medicine | 1611 S Locust Ave, Suite 200b, Lawrenceburg, TN 38464-4055 | 2016-01-21 |
| 1821488727 | Bruce Wilson Md PC | Internal Medicine | 5885 Airline Rd, # 985, Arlington, TN 38002-5127 | 2015-01-29 |
| 1982013215 | Blue Ridge Medical Management Corporation | Internal Medicine | 1901 S Shady St Ste 1, Mountain City, TN 37683-2021 | 2014-08-12 |
| 1871835892 | Robert Maxwell Smith | Internal Medicine | 1004 Deep Woods Trl, Brentwood, TN 37027-6309 | 2013-03-18 |
| 1750630794 | David Marc Mirvis | Internal Medicine | 5676 Redding Ave, Memphis, TN 38120-1848 | 2012-09-06 |
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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.