Individual provider Active NPI

Julio C Guerra, MD

  • Obstetrics & Gynecology Physician
  • Sevierville, TN
National Provider Identifier
1093752701
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
022020 Issued in TN
Practice address
1102 Foxwood Dr
Suite 31
Sevierville, TN 37862-9365
Phone
(865) 453-7717
Fax
(865) 428-8933
NPI assigned
Jun 1, 2006
Last updated
Aug 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 022020 TN Primary
Obstetrics & Gynecology Physician 207V00000X 43902 OK

Addresses

Primary practice location

1102 Foxwood Dr
Suite 31
Sevierville, TN 37862-9365

Mailing address

1102 Foxwood Dr
Suite 31
Sevierville, TN 37862-9365
Phone (865) 453-7717

Other practice location 1

1818 Kansas Ave
Woodward, OK 73801-2912
Phone (580) 256-2188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, OK2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220405002771 SD Practitioner - Obstetrics/Gynecology 3476717372 Reassigns benefits to 1 organization
I20240825000150 OK Practitioner - Obstetrics/Gynecology 3476717372 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Huron Regional Medical Center Inc CurrentSince Apr 1, 2022 Accepting new patients
Huron Regional Medical Center, Inc CurrentSince Apr 1, 2022 Accepting new patients
Huron Laboratory SVC PC Current Accepting new patients
Integris Ambulatory Care Corporation Obstetrics & Gynecology CurrentSince Jul 15, 2024 Accepting new patients
Integris Health Woodward Hospital Inc Past Accepting new patients
Integris Health Woodward Hospital Inc Past Accepting new patients

Locations

3001 Quail Springs Pkwy
Fl 5
Oklahoma City, OK 73134

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

900 17th St
Woodward, OK 73801
Phone (405) 610-4411

172 4th St SE
Huron, SD 57350
Phone (605) 353-6593

534 Oregon Ave SE
Huron, SD 57350
Phone (605) 353-7660

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1093752701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 FOXWOOD DR",
            "address_2": "SUITE 31",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378629365",
            "telephone_number": "865-453-7717",
            "fax_number": "865-428-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 FOXWOOD DR",
            "address_2": "SUITE 31",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378629365",
            "telephone_number": "865-453-7717",
            "fax_number": "865-428-8933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1818 Kansas Ave",
            "address_purpose": "LOCATION",
            "city": "Woodward",
            "state": "OK",
            "postal_code": "738012912",
            "country_code": "US",
            "telephone_number": "580-256-2188",
            "fax_number": "580-256-2281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "JULIO",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "022020",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "43902",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sevierville, TN

Sources for this page

Verify at the official NPI Registry.