EAST TENNESSEE STATE UNIVERSITY (NPI# 1851526826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851526826 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE STATE UNIVERSITY |
| Other Organization Name | JONESBOROUGH ELEMENTARY SCHOOL BASED CLINIC |
| Practice Address |
306 Forrest Dr Jonesborough TN 37659-1550 |
| Mailing Address |
Po Box 70403 365 Stout Drive Johnson City TN 37614-1703 |
| Practice Telephone | 4239133167 |
| Practice Fax Number | 4237531181 |
| Mailing Telephone | 4234394071 |
| Mailing Fax Number | 4234394060 |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2015-07-09 |
| Authorized Official Name | DR. DAVID C. COLLINS (CFO, VP FINANCE & ADMINISTRATION) |
| Authorized Official Telephone | 4234395884 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Jonesborough Elementary School Based 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 |
| 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 |
| 1295779361 | East Tennessee State University | Clinic/Center | 1901 S Shady Street, Mountain City, TN 37683-2601 | 2006-06-16 |
| 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 |
306 FORREST DR |
| City | JONESBOROUGH |
| State | TN |
| Zip Code | 37659-1550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538777669 | Megan Gilchrist | Pharmacist | 22 New Halifax St, Jonesborough, TN 37659 | 2020-07-15 |
| 1316414337 | Anna Brazell | Radiology | Lamont St and Veterans Way, Johnson City, TN 37659 | 2018-10-29 |
| 1952785081 | East Tennessee State University | Nurse Practitioner | 3261 Tn 81, Jonesborough, TN 37659 | 2015-07-18 |
| 1487907564 | Ashley Nugent Charfauros | Pharmacist | 1200 W. Jackson Blvd., Jonesborough, TN 37659 | 2012-10-26 |
| 1770871022 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 531 E Jackson Blvd, Jonesborough, TN 37659 | 2011-07-20 |
| 1548465784 | Cradic Chiropractic Center | Chiropractor | 206 Headtown Rd Suite 100, Jonesborough, TN 37659 | 2007-06-18 |
| 1265517197 | Jennie L. Walls | Nurse Practitioner | David Crockett High School Health Clinic, 684 Old State Route 34, Jonesborough, TN 37659 | 2006-10-26 |
| 1942262167 | Kenneth Weaver | Obstetrics & Gynecology | 1103 E Jackson Blvd, Ste 1, Jonesborough, TN 37659 | 2006-04-04 |
| 1326534082 | Hannah Ridley | Behavioral Analyst | 1015 Borowood Ct, Jonesborough, TN 37659 | 2018-07-06 |
| 1376044552 | Rural Health Services Consortium of Upper East Tennessee Inc | Clinic/Center | 600 Boones Creek Rd, Jonesborough, TN 37659 | 2018-02-23 |
| Find all providers in zip 37659 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508091562 | East Tennessee State University | Nurse Practitioner | 684 Old State Route 34, Jonesborough, TN 37659-6094 | 2009-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750982658 | Kirsten Marie Doerfer | Nurse Practitioner | 8512 Golden Cloud Ln, Knoxville, TN 37931-3164 | 2020-11-06 |
| 1912506551 | Anna Simpson Jones | Nurse Practitioner | 1042 E 3rd St Ste 103, Chattanooga, TN 37403-2161 | 2020-10-24 |
| 1033724349 | Tatum Lee Severino I | Nurse Practitioner | 8819 Three Chimneys Dr E, Germantown, TN 38138-8206 | 2020-09-14 |
| 1871106930 | Munira Asif | Nurse Practitioner | 874 Schilling Farm Rd Apt 106, Collierville, TN 38017-7039 | 2020-08-28 |
| 1669000840 | Tekeyla Warfield | Nurse Practitioner | 2980 Poplar Ave, Memphis, TN 38111-3527 | 2020-04-01 |
| 1578197836 | Jessica Pratt | Nurse Practitioner | 512 Marbury Rd, Tullahoma, TN 37388-2142 | 2020-02-26 |
| 1730729278 | Anna Abigail Markus | Nurse Practitioner | 211 Long Branch Rd, Lawrenceburg, TN 38464-5400 | 2020-01-13 |
| 1023653037 | Staci Garner | Nurse Practitioner | 2508 Highway 130, Petersburg, TN 37144-8001 | 2019-11-13 |
| 1881238533 | Janna Rae Haskins | Nurse Practitioner | 5137 Vinnie Dell Drive, Chapel Hill, TN 37034 | 2019-11-05 |
| 1124676325 | Marde M Walker | Nurse Practitioner | 8225 Highway 51 North, Millington, TN 38053 | 2019-08-30 |
| Find all providers with the same taxonomy | ||||
| City | JONESBOROUGH |
| Zip Code | 37659 |
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.