Active NPI
Gwyneth Davis Mabry
- Attendant Care Provider
- Soddy Daisy, TN
National Provider Identifier
1104474972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Attendant Care Provider
- Practice address
- 9502 Glenda LN
Soddy Daisy, TN 37379-3444 - Phone
- (423) 991-8907
- NPI assigned
- Aug 26, 2019
- 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 |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | Primary |
Addresses
Primary practice location
9502 Glenda LN
Soddy Daisy, TN 37379-3444
Mailing address
9502 Glenda LN
Soddy Daisy, TN 37379-3444
Phone (423) 991-8907
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | scottemabry@gmail.com | Direct |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566777600000",
"number": "1104474972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9502 GLENDA LN",
"city": "SODDY DAISY",
"state": "TN",
"postal_code": "373793444",
"telephone_number": "423-991-8907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9502 GLENDA LN",
"city": "SODDY DAISY",
"state": "TN",
"postal_code": "373793444",
"telephone_number": "423-991-8907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MABRY",
"first_name": "GWYNETH",
"middle_name": "DAVIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-26",
"last_updated": "2019-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "scottemabry@gmail.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "9502 Glenda Ln",
"city": "Soddy Daisy",
"state": "TN",
"country_code": "US",
"postal_code": "373793444",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Soddy Daisy, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.