Individual provider Active NPI

Tasheema Lanell Fair, M.D

  • Obstetrics & Gynecology Physician
  • Maryville, TN
National Provider Identifier
1164613816
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
1655 Issued in GA
Practice address
250 Cherokee Professional Park
Maryville, TN 37804-5153
Phone
(865) 681-0103
NPI assigned
Aug 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 1655 GA Primary
Obstetrics & Gynecology Physician 207V00000X 51464 TN

Addresses

Primary practice location

250 Cherokee Professional Park
Maryville, TN 37804-5153

Mailing address

250 Cherokee Professional Park
Maryville, TN 37804-5153
Phone (865) 681-0103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150115001099 TN Practitioner - Obstetrics/Gynecology 0941524284 Reassigns benefits to 1 organization
I20191218001094 AL Practitioner - Obstetrics/Gynecology 0941524284 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1655GAMDObstetrics & Gynecology Physician
51464TNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Tennessee, P.C. Obstetrics & Gynecology CurrentSince Aug 29, 2019 Accepting new patients
Obhg Alabama, P.C. Obstetrics & Gynecology CurrentSince Mar 4, 2020 Accepting new patients

Locations

2010 Medical Center Dr
Homewood, AL 35209
Phone (205) 877-1930

3690 Grandview Pkwy
Vestavia, AL 35243
Phone (205) 592-1000

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

Interoperability endpoints

  • Direct secure messaging: tasheema.fair.1@7598.direct.athenahealth.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1164613816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CHEROKEE PROFESSIONAL PARK",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045153",
            "telephone_number": "865-681-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CHEROKEE PROFESSIONAL PARK",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045153",
            "telephone_number": "865-681-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIR",
        "first_name": "TASHEEMA",
        "middle_name": "LANELL",
        "name_prefix": "Ms.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "1655",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "51464",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.