Active NPI
Lea Roque Garcia, M.T.
- Contractor
- Maryville, TN
National Provider Identifier
1073748521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 0000005743
- Practice address
- 318 Camellia Trce
Maryville, TN 37801-3560 - Phone
- (865) 684-0224
- Fax
- (865) 981-2881
- NPI assigned
- May 27, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 0000005743 | TN | Primary |
Addresses
Primary practice location
318 Camellia Trce
Maryville, TN 37801-3560
Mailing address
318 Camellia Trce
Maryville, TN 37801-3560
Phone (865) 684-0224
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
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000005743 | TN | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243382400000",
"number": "1073748521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 CAMELLIA TRCE",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378013560",
"telephone_number": "865-684-0224",
"fax_number": "865-981-2881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 CAMELLIA TRCE",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378013560",
"telephone_number": "865-684-0224",
"fax_number": "865-981-2881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "LEA",
"middle_name": "ROQUE",
"credential": "M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-27",
"last_updated": "2009-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "TN",
"license": "0000005743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maryville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.