Phillip L & Charlotte C Dennison PTRS

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PHILLIP L & CHARLOTTE C DENNISON PTRS

Practice address

110 Carriage House Dr
Jackson, TN 38305-3938

Phone

(731) 664-7879

Fax

(731) 664-7810

NPI assigned

Oct 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Phillip L Dennison

Title

Owner

Phone

(731) 664-7879

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• SCOOTER UNLIMITED, JACKSON MEDICAL SUPPLY, LYMPHEDEMA TREATMENT COMPAN Doing business as

Locations

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357862400000",
    "number": "1316027261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CARRIAGE HOUSE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053938",
            "telephone_number": "731-664-7879",
            "fax_number": "731-664-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CARRIAGE HOUSE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053938",
            "telephone_number": "731-664-7879",
            "fax_number": "731-664-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP L & CHARLOTTE C DENNISON PTRS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2013-01-11",
        "status": "A",
        "authorized_official_last_name": "DENNISON",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-664-7879",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1454677",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4083665",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCOOTER UNLIMITED, JACKSON MEDICAL SUPPLY, LYMPHEDEMA TREATMENT COMPAN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jerry Peters, MD
• Daniel W Peterson
• Ebony Pettigrew
• Wendy Burks Pevahouse, APN
• Pharmacy Now, Inc
• Cynthia Suzette Phillips, D.PH.
• Hannah Paige Phillips, MSN, APRN, FNP-C
• Jenosha Trynae Phillips, RBT
• Jessica Phillips, OTA
• Kaitlyn B Phillips, DO

• Durable Medical Equipment & Medical Supplies in Jackson, TN
• Providers in Jackson, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.

Verify at the official NPI Registry.