Joanne E Backofen, M.D.
Individual provider Active NPI Anesthesiology Physician · Johnson City, TN
NPI 1114924537 · NPPES record last updated Nov 20, 2009
Key facts
- NPI
- 1114924537
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- MD0000024841 (TN)
- Practice address
- 1114 Sunset Dr
Ste 4
Johnson City, TN 37604-2969 - Phone
- (423) 283-0776
- Fax
- (423) 283-0549
- NPI assigned
- Jun 30, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD0000024841 | TN | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia and Pain Consultants,P.C. | Anesthesiology | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD0000024841 | TN | Yes |
Addresses
Primary practice location
1114 Sunset Dr
Ste 4
Johnson City, TN 37604-2969
Mailing address
PO Box 3727
Johnson City, TN 37602-3727
Phone (423) 283-0776
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3079258 | Medicaid | TN |
Other providers in Johnson City, TN
- Oluwatosin Oriola Ayanjoke
- Tariq Ayubi
- Borzou Azima
- Back to Health P.C.
- James Steven Backers
- Casey E. Bacon
- Charla Barefield Bacon
- Kimberly S Bacon
- Paul Ryan Bader
- Kristina Bagley
All providers in Johnson City, TN · Anesthesiology Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.