NPIMap

Organization Active NPI

Northeast Tennessee Medical Associates PLC

  • Family Medicine Physician
  • Elizabethton, TN
National Provider Identifier
1063511145
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11022 Issued in TN
Legal business name
NORTHEAST TENNESSEE MEDICAL ASSOCIATES PLC
Practice address
314 Rogosin Dr
Elizabethton, TN 37643-2904
Phone
(423) 542-5505
Fax
(423) 542-5573
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert S Reeves, MD
Title
Owner
Phone
(423) 542-5573

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 11022 TN Primary

Addresses

Primary practice location

314 Rogosin Dr
Elizabethton, TN 37643-2904

Mailing address

314 Rogosin Dr
Elizabethton, TN 37643-2904
Phone (423) 542-5505

National Provider Directory

National Provider Directory

Locations

926 W Oakland Ave
Ste 222
Johnson City, TN 37604
Phone (423) 282-3379

Practitioners & affiliated clinicians

Practitioners 5

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": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063511145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 ROGOSIN DR",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432904",
            "telephone_number": "423-542-5505",
            "fax_number": "423-542-5573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 ROGOSIN DR",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432904",
            "telephone_number": "423-542-5505",
            "fax_number": "423-542-5573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST TENNESSEE MEDICAL ASSOCIATES PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-542-5573",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "11022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethton, TN

Sources for this page

  • 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.