Organization Active NPI

OBGYN Professionals of Etn PC

  • Obstetrics & Gynecology Physician
  • Knoxville, TN
National Provider Identifier
1053597427
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
OBGYN PROFESSIONALS OF ETN PC
Practice address
9330 Park West Blvd
Suite 502
Knoxville, TN 37923
Phone
(865) 531-3303
Fax
(865) 531-1272
NPI assigned
Jan 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

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

Authorized official

Name
Kay Ramsey
Title
Ofc MGR
Phone
(865) 531-3303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

9330 Park West Blvd
Suite 502
Knoxville, TN 37923

Mailing address

9330 Park West Blvd
Suite 502
Knoxville, TN 37923
Phone (865) 531-3303

Other identifiers 1

IdentifierTypeStateIssuer
3720237MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000594 TN Part B Supplier - Clinic/Group Practice 1951295310 Receives reassigned benefits from 2 practitioners
Practice locations: Knoxville, TN

National Provider Directory

National Provider Directory

Locations

22201 Moross Rd
Ste 3
Grosse Pointe, MI 48236

22201 Moross Rd
Ste 370
Grosse Pointe Woods, MI 48236
Phone (313) 343-4585

27472 Schoenherr Rd
Ste 170
Warren, MI 48088

9330 Park West Blvd
Ste 502
Knoxville, TN 37923
Phone (865) 531-3303

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1053597427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 PARK WEST BLVD",
            "address_2": "SUITE 502",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37923",
            "telephone_number": "865-531-3303",
            "fax_number": "865-531-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 PARK WEST BLVD",
            "address_2": "SUITE 502",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37923",
            "telephone_number": "865-531-3303",
            "fax_number": "865-531-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBGYN PROFESSIONALS OF ETN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "RAMSEY",
        "authorized_official_first_name": "KAY",
        "authorized_official_title_or_position": "OFC MGR",
        "authorized_official_telephone_number": "865-531-3303"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3720237",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.