Dyersburg Health

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

DYERSBURG HEALTH

Practice address

400 E Tickle St
Dyersburg, TN 38024-3120

Phone

(731) 287-2400

Fax

(731) 285-9545

NPI assigned

Nov 14, 2018

Last updated

Oct 14, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Tina Prescott

Title

President and Ceo

Phone

(731) 541-5000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1134698673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505483",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505483",
            "telephone_number": "731-287-2400",
            "fax_number": "731-285-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E TICKLE ST",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243120",
            "telephone_number": "731-287-2400",
            "fax_number": "731-285-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYERSBURG HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-14",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "PRESCOTT",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "731-541-5000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• General Practice Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.