Active NPI
Keith Dugger
- Physical Therapy Assistant
- Elizabethton, TN
National Provider Identifier
1215374533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 5427
- Practice address
- 1975 W Elk Ave
Ste 1
Elizabethton, TN 37643-3787 - Phone
- (423) 543-0073
- NPI assigned
- May 28, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5427 | TN | Primary |
Addresses
Primary practice location
1975 W Elk Ave
Ste 1
Elizabethton, TN 37643-3787
Mailing address
1975 W Elk Ave
Ste 1
Elizabethton, TN 37643-3787
Phone (423) 543-0073
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5427 | Other | TN | STATE OF TENNESSEE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5427 | TN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369699200000",
"number": "1215374533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1975 W ELK AVE",
"address_2": "STE 1",
"city": "ELIZABETHTON",
"state": "TN",
"postal_code": "376433787",
"telephone_number": "423-543-0073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1975 W ELK AVE",
"address_2": "STE 1",
"city": "ELIZABETHTON",
"state": "TN",
"postal_code": "376433787",
"telephone_number": "423-543-0073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUGGER",
"first_name": "KEITH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-28",
"last_updated": "2013-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TN",
"license": "5427",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF TENNESSEE",
"identifier": "5427",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elizabethton, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.