Individual provider Active NPI

Aundrea L Gravell, R.R.T.

  • Registered Respiratory Therapist
  • Mountain Home, TN
National Provider Identifier
1114935244
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Respiratory TherapistTaxonomy code 227900000X
License
1127 Issued in TN
Practice address
Corner of Sidney and Lamont St
James H. Quillen/Vamc
Mountain Home, TN 37684
Phone
(423) 979-3500
Fax
(423) 979-3471
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Respiratory Therapist 227900000X 1127 TN Primary

Addresses

Primary practice location

Corner of Sidney and Lamont St
James H. Quillen/Vamc
Mountain Home, TN 37684

Mailing address

1132 Hidden Valley Dr
Jonesborough, TN 37659-6290
Phone (423) 788-0211

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

State licenses

LicenseStateTypeSpecialty
1127TNMDRegistered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114935244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 HIDDEN VALLEY DR",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376596290",
            "telephone_number": "423-788-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF SIDNEY AND LAMONT ST",
            "address_2": "JAMES H. QUILLEN/VAMC",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "37684",
            "telephone_number": "423-979-3500",
            "fax_number": "423-979-3471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVELL",
        "first_name": "AUNDREA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "R.R.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": "TN",
            "license": "1127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.