NPIMap

Organization Active NPI

Blount Gastroenterology Assoc PC

  • Gastroenterology Physician
  • Maryville, TN
National Provider Identifier
1144286709
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
BLOUNT GASTROENTEROLOGY ASSOC PC
Practice address
1706 E Lamar Alexander Pkwy
Maryville, TN 37804-6204
Phone
(865) 983-0073
Fax
(865) 984-1731
NPI assigned
Apr 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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

Authorized official

Name
Stuart Craig Jarvis, MD
Title
President
Phone
(865) 983-0073

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

1706 E Lamar Alexander Pkwy
Maryville, TN 37804-6204

Mailing address

1706 E Lamar Alexander Pkwy
Maryville, TN 37804-6204
Phone (865) 983-0073

Other identifiers 1

IdentifierTypeStateIssuer
3381364MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050624000539 TN Part B Supplier - Clinic/Group Practice 4880639368 Receives reassigned benefits from 7 practitioners
Practice locations: Maryville, TN

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

355 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5060

1706 E Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 983-0073

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1144286709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378046204",
            "telephone_number": "865-983-0073",
            "fax_number": "865-984-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378046204",
            "telephone_number": "865-983-0073",
            "fax_number": "865-984-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOUNT GASTROENTEROLOGY ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-24",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "JARVIS",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-983-0073",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3381364",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.