Individual provider Active NPI

Barry T Dority

  • Nurse Practitioner
  • Springfield, TN
National Provider Identifier
1215133400
Registry record updated Jan 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
12120 Issued in TN
Practice address
450 Northcrest Dr
Springfield, TN 37172-3972
Phone
(615) 384-1571
NPI assigned
Jun 25, 2007
Last updated
Jan 20, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 12120 TN Primary

Addresses

Primary practice location

450 Northcrest Dr
Springfield, TN 37172-3972

Mailing address

3125 Sandy Springs Rd
Pleasant View, TN 37146-2812
Phone (615) 384-1571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12120TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Northcrest Physician Services Inc Past Accepting new patients
Tristar Family Care, LLC Past Accepting new patients

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232409600000",
    "number": "1215133400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 SANDY SPRINGS RD",
            "city": "PLEASANT VIEW",
            "state": "TN",
            "postal_code": "371462812",
            "telephone_number": "615-384-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 NORTHCREST DR",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371723972",
            "telephone_number": "615-384-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORITY",
        "first_name": "BARRY",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2009-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "12120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, TN

Sources for this page

Verify at the official NPI Registry.