DR. CORY V TRICKETT (NPI# 1922158500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1922158500 |
Entity Type | Individual |
Full Name | DR. CORY V TRICKETT |
Credential | DO |
Practice Address |
3183 W State St Bristol TN 37620-1712 |
Mailing Address |
3551 Roger Brooke Dr Mche-qd(creds) San Antonio TX 78234-4504 |
Practice Telephone | 4237647131 |
Practice Fax Number | 4232453136 |
Enumeration Date | 2007-01-12 |
Last Update Date | 2019-02-12 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
3466 | TN | Allopathic & Osteopathic Physicians |
N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
10791 | ND | Allopathic & Osteopathic Physicians |
N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
73663 | GA | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
3551 Roger Brooke Dr, San Antonio, TX 782344504 | 2109163400 |
Street Address |
3183 W STATE ST |
City | BRISTOL |
State | TN |
Zip Code | 37620-1712 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528051208 | Douglas Paul Williams | Psychiatry & Neurology | 3183 W State St, Suite 1201, Bristol, TN 37620-1712 | 2005-08-26 |
1538428230 | Michelle L Painter | Nurse Practitioner | 3183 W State St, Suite 1101, Bristol, TN 37620-1712 | 2012-05-15 |
1184889115 | Brenda K Friend | Nurse Practitioner | 3183 W State St, Suite 1101, Bristol, TN 37620-1712 | 2008-07-18 |
1063623692 | Claudia F Corradino | Nurse Practitioner | 3183 W State St, Suite 1201, Bristol, TN 37620-1712 | 2007-05-25 |
1114042629 | Mountain Empire Neurological Associates PC | Specialist | 3183 W State St, Suite 1201, Bristol, TN 37620-1712 | 2007-03-21 |
1730205089 | Teresa Ann Martin | Nurse Practitioner | 3183 W State St, Suite 1201, Bristol, TN 37620-1712 | 2007-03-21 |
1962533661 | William J. Schermer Pllc | Dermatology | 3183 W State St, Suite 1102, Bristol, TN 37620-1712 | 2007-03-07 |
1326053760 | Southeastern Pain Management Center, Pllc | Anesthesiology | 3183 W State St, Suite 1101, Bristol, TN 37620-1712 | 2006-07-31 |
1376588996 | Dennis M Aguirre | Pain Medicine | 3183 W State St, Suite1101, Bristol, TN 37620-1712 | 2006-06-18 |
1467430231 | William John Schermer | Dermatology | 3183 W State St, Suite 1102, Bristol, TN 37620-1712 | 2006-01-03 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376180216 | Firstep, LLC | Psychiatry & Neurology | 3183 W. State St., Suite 1201, Bristol, TN 37620 | 2019-12-10 |
1578047726 | Amanda Harville Mcgrady | Psychologist | 105 Walnut Circle, Bristol, TN 37620 | 2018-09-23 |
1467932533 | Teresa Mooney | Nurse Practitioner | 324 Leslie Ct, Bristol, TN 37620 | 2018-08-17 |
1992285308 | Jeremy Aurbrey Blanzy | Nurse Practitioner | 1 Medical Park Boulevard, Suite 400e, Bristol, TN 37620 | 2018-08-15 |
1255841805 | Amanda L Pillion | Audiologist | 225 Midway Medical Park, Bristol, VA 37620 | 2017-10-10 |
1841717717 | Joel Blevins | Driver | 301 Webb Ct, Bristol, TN 37620 | 2017-08-23 |
1831579796 | Dr. Marie Crawford, Ph.d., Pllc | Psychologist | 739 Bluff City Highway, Suite 5, Bristol, TN 37620 | 2015-06-05 |
1508297169 | Cassandra Marie Conry | Chiropractor | 800 Hill St., Bristol, TN 37620 | 2013-12-09 |
1780025874 | Laura Leann Lawson-renfro | Nurse Practitioner | 260 Midway St, Bristol, TN 37620 | 2013-07-17 |
1760822365 | Ricky Bhimani | Internal Medicine | 208 Medical Park Boulevard, Bristol, TN 37620 | 2013-06-27 |
Find all providers in zip 37620 |
Taxonomy Code | 207ND0101X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
Specialization | MOHS-Micrographic Surgery |
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295824415 | Tricities Skin and Cancer | Dermatology | 1009 N State of Franklin Access Road Suite A, Johnson City, TN 37604 | 2006-10-12 |
1457448599 | Brent Moody | Dermatology | 1900 Patterson St Ste 201, Nashville, TN 37203 | 2006-10-09 |
1942238902 | East Tennessee Medical Group, PC | Dermatology | 266 Joule Street, Alcoa, TN 37701-2422 | 2006-06-29 |
1881658243 | Adult & Pediatric Dermatology of Tullahoma PC | Dermatology | 100 William Northern Blvd, Ste C, Tullahoma, TN 37388 | 2006-04-13 |
1851369391 | Thomas Paul Chu | Dermatology | 520 Trinity Creek Cv, Cordova, TN 38018-2279 | 2006-03-10 |
1770550659 | Frances Beard | Dermatology | 1455 Union Avenue, Memphis, TN 38104-6727 | 2006-03-01 |
1275506404 | Rex Allen Amonette | Dermatology | 1455 Union Ave, Memphis, TN 38104-6727 | 2006-02-08 |
1184608416 | Julie M Pena | Dermatology | 200 Cool Springs Blvd, Franklin, TN 37067-2677 | 2005-11-30 |
1306849500 | Steve Leroy Peterson | Dermatology | 1009 North State of Franklin Access Road, Johnson City, TN 37604 | 2005-05-23 |
1255938502 | Uderm, Pllc | Dermatology | 5243 Little Debbie Pkwy Ste 111, Ooltewah, TN 37363-4515 | 2020-10-08 |
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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.