NPIMap

Organization Active NPI

Northeast Tennessee Emergency Physicians PC

  • Emergency Medicine Physician
  • Rogersville, TN
National Provider Identifier
1063797439
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
NORTHEAST TENNESSEE EMERGENCY PHYSICIANS PC
Practice address
851 Locust St
Rogersville, TN 37857-2407
Phone
(423) 639-3151
Fax
(423) 398-5500
NPI assigned
Oct 18, 2011
Last updated
Oct 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2011

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

Authorized official

Name
John Mark Woodard, MD
Title
President
Phone
(423) 408-2960

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

851 Locust St
Rogersville, TN 37857-2407

Mailing address

PO Box 11827
Daytona Beach, FL 32120-1827
Phone (386) 274-7800

National Provider Directory

National Provider Directory
Tax ID family
Northeast Tennessee Emergency Physicians PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1063797439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11827",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321201827",
            "telephone_number": "386-274-7800",
            "fax_number": "386-274-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 LOCUST ST",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378572407",
            "telephone_number": "423-639-3151",
            "fax_number": "423-398-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST TENNESSEE EMERGENCY PHYSICIANS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-18",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-408-2960",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogersville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; 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.