SMOKIE MOUNTAIN DIALYSIS INC. (NPI# 1417031071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417031071 |
| Entity Type | Organization |
| Organization Name | SMOKIE MOUNTAIN DIALYSIS INC. |
| Practice Address |
101 Med Tech Pkwy Suite 406 Johnson City TN 37604-4007 |
| Mailing Address |
Po Box 4087 Johnson City TN 37602-4087 |
| Practice Telephone | 4232328882 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2011-04-04 |
| Authorized Official Name | STANLEY EUGENE VERMILLION (PRESIDENT) |
| Authorized Official Telephone | 4232328882 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 4146761 | 05 |
| Street Address |
101 MED TECH PKWY SUITE 406 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-4007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205830536 | Fernando Bendfeldt | Psychiatry & Neurology | 101 Med Tech Pkwy, Ste 407, Johnson City, TN 37604-4000 | 2005-05-23 |
| 1558669986 | Caitlen M Petschke | Physician Assistant | 101 Med Tech Pkwy, Ste. 405, Johnson City, TN 37604-4007 | 2011-03-09 |
| 1023319290 | John Argerson | Specialist | 101 Med Tech Pkwy, Suite 402, Johnson City, TN 37604-4007 | 2010-11-04 |
| 1962655696 | Pain Medicine Associates, P.C. | Psychologist | 101 Med Tech Pkwy, Suite 200, Johnson City, TN 37604-4007 | 2008-10-28 |
| 1679722052 | Michael M Wilkinson | Anesthesiology | 101 Med Tech Pkwy, Johnson City, TN 37604-4007 | 2008-09-10 |
| 1548422355 | Pma Surgery Center LLC | Psychologist | 101 Med Tech Pkwy, Suite 205, Johnson City, TN 37604-4007 | 2008-07-02 |
| 1942475439 | Tri Cities Esthetics, Inc. | Specialist | 101 Med Tech Pkwy, Suite 402, Johnson City, TN 37604-4007 | 2008-04-25 |
| 1821158031 | Alison Repass Herrig | Nurse Practitioner | 101 Med Tech Pkwy, Suite 405, Johnson City, TN 37604-4007 | 2006-12-11 |
| 1053496901 | Mountain States Health Alliance | Durable Medical Equipment & Medical Supplies | 101 Med Tech Pkwy, Suite 100, Johnson City, TN 37604-4007 | 2006-10-26 |
| 1922191238 | James A Ross | Emergency Medicine | 101 Med Tech Pkwy, Suite 305, Johnson City, TN 37604-4007 | 2006-10-02 |
| 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 | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184994576 | Latrobe Dialysis LLC | Clinic/Center | 2320 Knob Creek Rd Ste 408, Johnson City, TN 37604-2581 | 2012-01-03 |
| 1215049044 | National Medical Care, Inc. | Clinic/Center | 100 Technology Ln, Johnson City, TN 37604-2004 | 2006-08-31 |
| 1902851033 | Tennessee Valley Dialysis Center LLC | Clinic/Center | 107 Woodlawn Dr, Ste 2, Johnson City, TN 37604-6287 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831736438 | Fresenius Medical Care Cookeville, LLC | Clinic/Center | 117 N Hickory Ave Ste 100, Cookeville, TN 38501-2424 | 2019-12-03 |
| 1245872829 | Pure Life Renal of Cool Springs, LLC | Clinic/Center | 1648 Westgate Cir Ste 100, Brentwood, TN 37027-8019 | 2019-10-15 |
| 1386298560 | Mattapan Dialysis LLC | Clinic/Center | 5144 Riverdale Rd Ste 103, Memphis, TN 38141-0271 | 2019-07-26 |
| 1114480761 | Avail Southeast Kidney Care LLC | Clinic/Center | 2008 Brookside Dr Ste 100, Kingsport, TN 37660-4640 | 2019-04-10 |
| 1609337161 | Dialysis Clinic Inc | Clinic/Center | 5653 Frist Blvd Ste 334, Hermitage, TN 37076-2064 | 2019-03-27 |
| 1972062669 | Dialyze Direct Tn, LLC | Clinic/Center | 2600 Thousand Oaks Blvd Ste 1400, Memphis, TN 38118-2401 | 2019-03-13 |
| 1336610757 | Fresenius Medical Care Columbia Franklin, LLC | Clinic/Center | 8048 Station Hill Drive, Spring Hill, TN 37174 | 2018-12-11 |
| 1770052888 | Bio-medical Applications of Tennessee, Inc. | Clinic/Center | 6085 Arbury Way, Ooltewah, TN 37363 | 2018-11-19 |
| 1164907929 | Fresenius Medical Care Sandy River, LLC | Clinic/Center | 57 Commerce St, Paris, TN 38242-4917 | 2018-09-27 |
| 1003390469 | Isd Renal Inc | Clinic/Center | 1843 Foreman Dr Ste 201, Cookeville, TN 38501-5933 | 2018-09-21 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
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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.