Surgical Group of Northeast Tennessee

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD0000026800 Issued in TN

Legal business name

SURGICAL GROUP OF NORTHEAST TENNESSEE

Practice address

361 Okolona Dr
Erwin, TN 37650-2183

Phone

(423) 743-4151

Fax

(423) 743-7580

NPI assigned

Aug 31, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Edward Johnson Fore, M.D.NPI 1346221157

Title

Medical Doctor

Phone

(423) 743-4151

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward Johnson Fore, M.D.

  • Family Medicine Physician
  • Kingsport, TN
  • NPI 1346221157

  Surgery

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043322415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 OKOLONA DR",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376502183",
            "telephone_number": "423-743-4151",
            "fax_number": "423-743-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 OKOLONA DR",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376502183",
            "telephone_number": "423-743-4151",
            "fax_number": "423-743-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL GROUP OF NORTHEAST TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "423-743-4151",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD0000026800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3700364",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trula Jean Sneyd, CNA 2
• Joseph C Snyder Jr., DPH
• Tommy South, LCSW
• Jason Anthony Sparks, PHARMD
• State of Tennessee (Unicoi County Health Department)
• Melodie K Swanson, PHARMD
• Suzonne S Swihart, RN NP
• Celeste Carol Taylor, LPC
• TLC Mobile Clinic, LLC
• Joel J Troy, RPH

• Surgery Physician in Erwin, TN
• Providers in Erwin, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.