DRS MONTENEGRO & DE WIT (NPI# 1972602894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972602894 |
| Entity Type | Organization |
| Organization Name | DRS MONTENEGRO & DE WIT |
| Practice Address |
310 N State of Franklin Rd Suite 201 Johnson City TN 37604-6008 |
| Practice Telephone | 4239283051 |
| Practice Fax Number | 4239288840 |
| Mailing Telephone | 4239283051 |
| Mailing Fax Number | 4239288840 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ALBERTINE DE WIT (OWNER) |
| Authorized Official Telephone | 4239283051 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 013647 | TN | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3382675 | 05 | |
| TN | TRIGON BCBS | 129760 | 01 |
| TN | BCBS | 15491 | 01 |
| Street Address |
310 N STATE OF FRANKLIN RD SUITE 201 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-6008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598769903 | Pamela L. Greer | Nurse Practitioner | 310 N State of Franklin Rd, Ste 202, Johnson City, TN 37604-6063 | 2005-06-13 |
| 1659817377 | Shandon Morrison | Nurse Practitioner | 310 N State of Franklin Rd, Suite 202, Johnson City, TN 37604-6008 | 2017-01-19 |
| 1366990442 | Michelle L Jones | Nurse Practitioner | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6008 | 2016-09-16 |
| 1881147692 | Deretsa Perry | Nurse Practitioner | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6008 | 2016-07-28 |
| 1053762112 | Blue Ridge Medical Management Corporation | Internal Medicine | 310 N State of Franklin Rd, Ste 301a, Johnson City, TN 37604-6008 | 2016-06-29 |
| 1669864377 | Emily Kathleen Price | Nurse Practitioner | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6008 | 2015-03-04 |
| 1366862336 | Miranda Kyker | Nurse Practitioner | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6008 | 2014-04-17 |
| 1114340445 | Blue Ridge Medical Management | Surgery | 310 N State of Franklin Rd, Suite 101b, Johnson City, TN 37604-6008 | 2014-01-22 |
| 1225389349 | Trinity Cancer Care, P.C. | Internal Medicine | 310 N State of Franklin Rd, Suite 401, Johnson City, TN 37604-6073 | 2012-09-28 |
| 1285936930 | Ryan Kara Judson | Nurse Practitioner | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6008 | 2010-12-01 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144620881 | Jennifer Spalik | Specialist | 167 N Hudson St, Johnson City, NY 13790-1414 | 2014-08-29 |
| 1417128968 | The Michal Child Development Center | Specialist | 302 Wesley St Ste 10, Johnson City, TN 37601-1769 | 2008-03-12 |
| 1922278480 | Mountainview Oral & Maxillofacial Surgery, P.C. | Specialist | 535 Columbia Dr, Johnson City, NY 13790-3302 | 2008-03-11 |
| 1346390937 | East Tennessee Anesthesia Services. LLC | Specialist | 221 Shadowood Dr, Johnson City, TN 37604-1128 | 2007-01-12 |
| 1962429647 | Tri-state Cardiology | Specialist | 2408 Susannah St, Ste.1, Johnson City, TN 37601-1728 | 2006-07-17 |
| 1366476657 | Gauri K Bhardwaj | Specialist | 699 Main St, Johnson City, NY 13790-1743 | 2006-07-10 |
| 1235168949 | Gamal S Boutros | Specialist | 329 Wesley Street, Suite 1, Johnson City, TN 37601-1721 | 2006-07-03 |
| 1740216910 | Daniel M O'roark | Specialist | 701 N State of Franklin Rd, Ste 9, Johnson City, TN 37604-3645 | 2006-06-22 |
| 1336135011 | Mohamad Isam Abdelazim | Specialist | 700 Harry L Dr, Johnson City, NY 13790-1145 | 2005-09-27 |
| 1922009521 | Elizabeth C. Smith | Specialist | 302 Wesley St, Suite 10, Johnson City, TN 37601-1740 | 2005-08-03 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
Please comment or provide details below to improve the information on DRS MONTENEGRO & DE WIT.
| 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.