GENESIA DICKSON IRICK (NPI# 1811431406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811431406 |
| Entity Type | Individual |
| Full Name | GENESIA DICKSON IRICK |
| Credential | FNP |
| Practice Address |
10461 Wallace Alley St Kingsport TN 37663-3936 |
| Mailing Address |
2756 Bob Little Rd Elizabethton TN 37643-7222 |
| Practice Telephone | 4232791400 |
| Practice Fax Number | 4232791410 |
| Mailing Telephone | 4232022274 |
| Mailing Fax Number | 4232791410 |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2016-12-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
22008 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
10461 WALLACE ALLEY ST |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37663-3936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700887106 | Jeffrey P Fenyves | Internal Medicine | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2005-08-09 |
| 1972777845 | Ahp of East Tennessee Pllc | Nurse Anesthetist, Certified Registered | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2008-04-22 |
| 1487870077 | Ashley Laine Anderson | Nurse Practitioner | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2007-04-18 |
| 1780796003 | Viktor P Sulkowski | Specialist | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2006-08-31 |
| 1669584991 | East Tennessee Anesthesia Providers, PC | Specialist | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2006-08-31 |
| 1083639918 | Tri-cities Gastroenterology LLC | Internal Medicine | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2006-07-13 |
| 1063437994 | Tri-cities Endoscopy Center PC | Clinic/Center | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2006-07-13 |
| 1750382982 | Stephen W Fry | Internal Medicine | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2005-08-10 |
| 1497756787 | Susanne S Mckinney | Registered Nurse | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649528126 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 1567 North Eastman Road, Kingsport, TN 37663 | 2012-08-15 |
| 1548546419 | Vickie R Harris | Counselor | 317 Pitt Road, Kingsport, TN 37663 | 2011-10-24 |
| 1467746446 | Eric A. Echard | Dentist | 1339 Moreland Drive, Suite 1, Kingsport, TN 37663 | 2011-06-07 |
| 1619003399 | Colonial Heights Pharmacy, Inc. | Pharmacy | 4221 Ft. Henry Drive, Kingsport, TN 37663 | 2007-02-26 |
| 1316005986 | Robert F Mcamis Jr. | Dentist | 4016 Fort Henry Drive, Kingsport, TN 37663 | 2006-12-05 |
| 1467567412 | Colonial Heights Dental Assocaites | Dentist | 150 Clinic Drive, Suite A, Kingsport, TN 37663 | 2006-08-20 |
| 1194777953 | Nicholas Brett Smith | Family Medicine | 4600 Fort Henry Dr, Kingsport, TN 37663 | 2006-05-17 |
| 1396720108 | Resp-i-care, Inc. | Durable Medical Equipment & Medical Supplies | 648 Eastern Star Rd, Kingsport, TN 37663 | 2005-12-14 |
| 1023000429 | Darryl Fontaine | Anesthesiology | 4105 Fort Henry Drive, Suite 207, Kingsport, TN 37663 | 2005-08-22 |
| 1659701696 | Jordan Burke | Physician Assistant | 4600 Fort Henry Dr, Kingsport, TN 37663 | 2013-11-12 |
| Find all providers in zip 37663 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750911202 | Felicia Grace Berry | Nurse Practitioner | 2204 Pavilion Dr Ste 210, Kingsport, TN 37660-4652 | 2020-01-23 |
| 1205399508 | Michael David Thacker | Nurse Practitioner | 100 Clinchfield St, Kingsport, TN 37660-3681 | 2019-04-12 |
| 1871058263 | Lisa Marie Ketchem | Nurse Practitioner | 5039 Andrew St, Kingsport, TN 37660-6500 | 2019-02-10 |
| 1972067395 | Alice Victoria Lilly | Nurse Practitioner | 2995 Ft. Henry Drive, Suite 100, Kingsport, TN 37664 | 2019-01-30 |
| 1720542376 | Amanda Michelle Oliver | Nurse Practitioner | 404 Manor Dr Apt F, Kingsport, TN 37660-3471 | 2019-01-29 |
| 1750857439 | Ashlee Fleming | Nurse Practitioner | 105 W Stone Dr Ste 4c, Kingsport, TN 37660-3365 | 2018-10-19 |
| 1497220214 | Melanie Creppel Bourgeois | Nurse Practitioner | 4606 Sundown Dr, Kingsport, TN 37664-6913 | 2018-10-08 |
| 1013493147 | Cathy A Greenwood | Nurse Practitioner | 3136 Winesap Rd, Kingsport, TN 37663-2920 | 2018-07-11 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1235641630 | Bethany Monique Rock | Nurse Practitioner | 3716 Thorngrove Dr, Kingsport, TN 37660-2243 | 2017-10-26 |
| Find all providers in KINGSPORT | ||||
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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.