Wendy Ann Kauffman

Key facts

NPI

1124873435

Entity type

Individual (NPI type 1)

Primary specialty

Technician/Technologist 156F00000X

Practice address

101 Dillon CT
Gray, TN 37615-3555

Phone

(423) 477-2440

NPI assigned

Apr 19, 2024

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 19, 2024.

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1124873435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4136 VAN HILL RD",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377456107",
            "telephone_number": "573-823-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DILLON CT",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376153555",
            "telephone_number": "423-477-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFFMAN",
        "first_name": "WENDY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Gray, TN · Technician/Technologist in Tennessee