EAST TENNESSEE STATE UNIVERSITY (NPI# 1861666562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861666562 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE STATE UNIVERSITY |
| Other Organization Name | ETSU HIGH RISK CLINIC |
| Practice Address |
325 N State of Franklin Rd (ground Floor With Pediatrics) Johnson City TN 37604-6062 |
| Mailing Address |
Po Box 70403 Johnson City TN 37614-1703 |
| Practice Telephone | 4234394355 |
| Practice Fax Number | 4234394607 |
| Mailing Telephone | 4234394078 |
| Mailing Fax Number | 4234394060 |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-09-11 |
| Authorized Official Name | DAVID D. COLLINS (CFO, VP FINANCE & ADMINISTRATION) |
| Authorized Official Telephone | 4234395884 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| Y | 231H00000X | Audiologist | Speech, Language and Hearing Service Providers |
| Other Name | Type Code |
|---|---|
| ETSU High Risk Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275902884 | East Tennessee State University | Nurse Practitioner | 1000 N Roan St, Johnson City, TN 37601-4616 | 2015-09-24 |
| 1952785081 | East Tennessee State University | Nurse Practitioner | 3261 Tn 81, Jonesborough, TN 37659 | 2015-07-18 |
| 1982905576 | East Tennessee State University | Clinic/Center | 1134-1136 E. Main Street, Johnson City, TN 37601 | 2010-11-12 |
| 1851526826 | East Tennessee State University | Nurse Practitioner | 306 Forrest Dr, Jonesborough, TN 37659-1550 | 2009-05-20 |
| 1548422330 | East Tennessee State University | Audiologist | 837 Pardee St, Johnson City, TN 37601-5900 | 2008-07-02 |
| 1942474762 | East Tennessee State University | Speech-Language Pathologist | 300 Urbana Rd, Limestone, TN 37681-2824 | 2008-04-14 |
| 1093990608 | East Tennessee State University | Clinic/Center | 202 W Fairview Ave, Johnson City, TN 37604-5611 | 2008-01-02 |
| 1326142563 | East Tennessee State University | Nurse Practitioner | 391 Court Sq, Sneedville, TN 37869-0723 | 2006-09-08 |
| 1568570273 | East Tennessee State University | Nurse Practitioner | 365 Stout Drive, Nicks Hall Rm 160, Johnson City, TN 37614-6500 | 2006-08-25 |
| 1215045976 | East Tennessee State University | Nurse Practitioner | 2700 Main Street, Sneedville, TN 37869-0723 | 2006-08-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EAST TENNESSEE STATE UNIVERSITY | 2109 W Market St, Johnson City, TN 37604-6024 |
| Street Address |
325 N STATE OF FRANKLIN RD (GROUND FLOOR WITH PEDIATRICS) |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-6062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669477022 | Kent Hjerpe | Specialist | 325 N State of Franklin Rd, First Floor, Johnson City, TN 37604-6056 | 2005-06-14 |
| 1770195950 | Tripti Sharma | Student in an Organized Health Care Education/Training Program | 325 N State of Franklin Rd, Johnson City, TN 37604-6056 | 2020-08-19 |
| 1922617869 | Melanie Natasha Rayan | Student in an Organized Health Care Education/Training Program | 325 N State of Franklin Rd, Johnson City, TN 37604-6056 | 2020-07-27 |
| 1700494754 | Fares Ghanem | Student in an Organized Health Care Education/Training Program | 325 N State of Franklin Rd, Johnson City, TN 37604-6056 | 2020-07-16 |
| 1821606047 | Nizar Obeidat | Student in an Organized Health Care Education/Training Program | 325 N State of Franklin Rd, Johnson City, TN 37604-6056 | 2020-07-14 |
| 1578188603 | Ahmad Samih Al Tamari | Student in an Organized Health Care Education/Training Program | 325 N State of Franklin Rd, Johnson City, TN 37604-6056 | 2020-06-15 |
| 1548883424 | Elizabeth Van Buren | Student in an Organized Health Care Education/Training Program | 325 N State of Franklin Rd, Johnson City, TN 37604-6056 | 2020-05-26 |
| 1881216653 | Andres Rene Diaz | Student in an Organized Health Care Education/Training Program | 325 N State of Franklin Rd, Johnson City, TN 37604-6056 | 2020-05-14 |
| 1912528860 | Eric Bookout | Student in an Organized Health Care Education/Training Program | 325 N State of Franklin Rd, Johnson City, TN 37604-6056 | 2020-05-01 |
| 1619597309 | Sarah Tolliver | Student in an Organized Health Care Education/Training Program | 325 N State of Franklin Rd, Johnson City, TN 37604-6056 | 2020-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560707 | Brant Logan Nickens | Physical Therapist | 809 Lamont St and Veterans Way, Johnson City, TN 37604 | 2020-08-26 |
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| Find all providers in zip 37604 | ||||
| Taxonomy Code | 231H00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Audiologist |
| (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. |
| Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164978383 | Thomas J Hladnik Jr. | Audiologist | 3060 Franklin Terrace Drive, Hearing Aid Center, Johnson City, TN 37604-4123 | 2016-08-28 |
| 1639503287 | Johnson Hearing Technology and Communication, Pllc | Audiologist | 2831 E Oakland Ave Ste 2, Johnson City, TN 37601-1300 | 2013-08-29 |
| 1417298969 | Marcy Kay Hite | Audiologist | 156 South Dossett Drive, Johnson City, TN 37614-1702 | 2013-03-08 |
| 1548422330 | East Tennessee State University | Audiologist | 837 Pardee St, Johnson City, TN 37601-5900 | 2008-07-02 |
| 1629284906 | Sarah A Schumaier | Audiologist | 106 E. Watauga Avenue, Johnson City, TN 37601 | 2007-05-15 |
| 1932284221 | Jennifer Blevins Robinson | Audiologist | 204 Dogwood Ave., Department of Veterans Affairs Medical Center (126), Johnson City, TN 37684 | 2006-10-26 |
| 1861589517 | Christopher Andrew Burks | Audiologist | 306 Sunset Dr, Suite 103, Johnson City, TN 37604-2492 | 2006-10-06 |
| 1851487953 | Russell James Fankhouser | Audiologist | 306 Sunset Drive, Suite 103, Johnson City, TN 37604 | 2006-10-05 |
| 1962432609 | Medical Education Assistance Corporation | Audiologist | 156 S Dossett Drive, Johnson City, TN 37614-1702 | 2006-07-04 |
| 1770527053 | Daniel R. Schumaier | Audiologist | 106 E Watauga Ave, Johnson City, TN 37601-4628 | 2006-06-16 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
Please comment or provide details below to improve the information on EAST TENNESSEE STATE UNIVERSITY.
| 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.