Paul Diers, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA000243 Issued in TN

Practice address

2202 John B Dennis Hwy
Suite 100
Kingsport, TN 37660

Phone

(423) 245-3161

Fax

(423) 857-8129

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Appalachian Orthopaedic Associates P C

  • Orthopaedic Surgery Physician
  • Kingsport, TN
  • NPI 1669940078
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1124060140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 JOHN B DENNIS HWY",
            "address_2": "SUITE 100",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37660",
            "telephone_number": "423-245-3161",
            "fax_number": "423-857-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 JOHN B DENNIS HWY",
            "address_2": "SUITE 100",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37660",
            "telephone_number": "423-245-3161",
            "fax_number": "423-857-8129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIERS",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA000243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA000243",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3669582",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008929785",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen E Dexter, M.D.
• Kyle J Dickall
• Debra D Dickens, RN
• Ernest Dickson, PT
• Heather Jeanette Dickson, PMHNP
• Daniel Martin Dietrich, D.D.S.
• Kelli Lynn Dillon, BSW
• Bradley Bishop Diminick, DDS
• Marin Dimitrov, MD
• Marcie Dingus, PHARMD

• Physician Assistant in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; 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.