Bancroft Oquinn Jr., MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MD0000018417 Issued in TN

Practice address

1405 West Baddour Parkway
Suite 106
Lebanon, TN 37087

Phone

(615) 444-6500

Fax

(615) 449-1306

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1184640336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 BADDOUR PARKWAY",
            "address_2": "SUITE 106",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "37087",
            "telephone_number": "615-444-6500",
            "fax_number": "615-449-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 WEST BADDOUR PARKWAY",
            "address_2": "SUITE 106",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "37087",
            "telephone_number": "615-444-6500",
            "fax_number": "615-449-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OQUINN",
        "first_name": "BANCROFT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TN",
            "license": "18417",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TN",
            "license": "MD0000018417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUUE CROSS",
            "identifier": "73029",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3029464",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4066065",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology Physician in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Otolaryngology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.