Active NPI
Everett Ellison McDuffie, M.D.
- Psychiatry Physician
- Blountville, TN
National Provider Identifier
1124032479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 40958
- Practice address
- 200 Deck LN
Unit 1001
Blountville, TN 37617-6339 - Phone
- (423) 573-1409
- NPI assigned
- Jul 29, 2006
- Last updated
- Apr 9, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 40958 | TN | Primary |
Addresses
Primary practice location
200 Deck LN
Unit 1001
Blountville, TN 37617-6339
Mailing address
200 Deck LN
Unit 1001
Blountville, TN 37617-6339
Phone (423) 573-1409
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40958 | TN | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207699200000",
"number": "1124032479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 DECK LN",
"address_2": "UNIT 1001",
"city": "BLOUNTVILLE",
"state": "TN",
"postal_code": "376176339",
"telephone_number": "423-573-1409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 DECK LN",
"address_2": "UNIT 1001",
"city": "BLOUNTVILLE",
"state": "TN",
"postal_code": "376176339",
"telephone_number": "423-573-1409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDUFFIE",
"first_name": "EVERETT",
"middle_name": "ELLISON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-29",
"last_updated": "2008-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TN",
"license": "40958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blountville, TN
- Sarah E Linnane, CPM, CPM-TN
- Chelsea Paige Long, REGISTERED NURSE
- Autumn Samantha Longworth, CRNA
- Russell B Mantooth, PHARMD
- Mark a. Bowers (Blountville Family Eyecare)
- Heather Leann McElyea
- Kelly McKaig
- Medexpress Urgent Care, PC - Virginia (MedExpress Urgent Care - Nick Patel, M.D.)
- Michael Miller Messamore
- Rebecca Jean Miller
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.