Innovative Sleep Diagnostics, LLC

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Legal business name

INNOVATIVE SLEEP DIAGNOSTICS, LLC

Practice address

1104 Tusculum Blvd
Ste 301
Greeneville, TN 37745-4091

Phone

(423) 764-1579

NPI assigned

Jul 25, 2007

Last updated

Oct 18, 2007By 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

Mr. Jimmie Royce Daugherty II

Title

President

Phone

(423) 764-4480

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1205026499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MEADOWVIEW RD",
            "address_2": "STE 2",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201725",
            "telephone_number": "423-764-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 TUSCULUM BLVD",
            "address_2": "STE 301",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454091",
            "telephone_number": "423-764-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE SLEEP DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "DAUGHERTY",
        "authorized_official_first_name": "JIMMIE",
        "authorized_official_middle_name": "ROYCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-764-4480",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sleep Disorder Diagnostic Clinic/Center in Greeneville, TN
• Providers in Greeneville, TN by specialty
• Sleep Disorder Diagnostic Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.