Active NPI
John Robert Vincent, M.D.
- Specialist
- Germantown, TN
National Provider Identifier
1023216470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 02495
- Practice address
- 8573 Cordes Cir
Germantown, TN 38139-3317 - Phone
- (901) 754-6733
- Fax
- (901) 754-7808
- NPI assigned
- Jul 6, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 02495 | TN | Primary |
Addresses
Primary practice location
8573 Cordes Cir
Germantown, TN 38139-3317
Mailing address
7398 W. Desoto Rd
Walls, MS 38680
Phone (662) 781-1289
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02495 | TN | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023216470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7398 W. DESOTO RD",
"city": "WALLS",
"state": "MS",
"postal_code": "38680",
"telephone_number": "662-781-1289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8573 CORDES CIR",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381393317",
"telephone_number": "901-754-6733",
"fax_number": "901-754-7808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINCENT",
"first_name": "JOHN",
"middle_name": "ROBERT",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TN",
"license": "02495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Germantown, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.