NPIMap

East Tennessee State University

A Medicare group practice based in Johnson City, TN: 13 NPIs enrolled under one PECOS associate control ID (PAC ID 2769394774), with 44 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
2769394774The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part A Provider - Federally Qualified Health Center (FQHC), Part B Supplier - Clinic/Group Practice
Enrolled in
TN
Enrollments
5
Group size
21 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
9In 2 places

Enrollment records 5

Enrollment IDStateProvider typeNPI
O20031002000000 TN Part A Provider - Federally Qualified Health Center (FQHC) 1326142563
O20031212000403 TN Part B Supplier - Clinic/Group Practice 1093990608
O20140416000866 TN Part A Provider - Federally Qualified Health Center (FQHC) 1093990608
O20100813000904 TN Part A Provider - Federally Qualified Health Center (FQHC) 1477660199
O20100927000795 TN Part A Provider - Federally Qualified Health Center (FQHC) 1215045976

NPIs in this group 13

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 44

Clinicians who reassign their Medicare benefits to this group (44) or whom Care Compare lists as members (21).

Sources for this page