NPIMap

Organization Active NPI

Stephen D. Pershing MD PLLC

  • Internal Medicine Physician
  • Vonore, TN
National Provider Identifier
1104159417
Registry record updated Sep 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD0000010526 Issued in TN
Legal business name
STEPHEN D. PERSHING MD PLLC
Practice address
125 Mountain View Dr
Suite 200
Vonore, TN 37885-2666
Phone
(423) 884-2308
Fax
(423) 884-2929
NPI assigned
Sep 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2009

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

Authorized official

Name
Dr. Stephen Douglas Pershing, M.D.
Title
Owner
Phone
(423) 884-2308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MD0000010526 TN Primary

Addresses

Primary practice location

125 Mountain View Dr
Suite 200
Vonore, TN 37885-2666

Mailing address

125 Mountain View Dr
Suite 200
Vonore, TN 37885-2666
Phone (423) 884-2308

National Provider Directory

National Provider Directory

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": "1253232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253232000000",
    "number": "1104159417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 MOUNTAIN VIEW DR",
            "address_2": "SUITE 200",
            "city": "VONORE",
            "state": "TN",
            "postal_code": "378852666",
            "telephone_number": "423-884-2308",
            "fax_number": "423-884-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MOUNTAIN VIEW DR",
            "address_2": "SUITE 200",
            "city": "VONORE",
            "state": "TN",
            "postal_code": "378852666",
            "telephone_number": "423-884-2308",
            "fax_number": "423-884-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN D. PERSHING MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-18",
        "last_updated": "2009-09-18",
        "status": "A",
        "authorized_official_last_name": "PERSHING",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-884-2308",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000010526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vonore, TN

Sources for this page

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

Verify at the official NPI Registry.