Elizabeth Heather Fairbank, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

034602 Issued in TN

Practice address

3786 Central Pike
# 130
Hermitage, TN 37076-3497

Phone

(615) 883-2200

Fax

(615) 883-1104

NPI assigned

Jan 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: admin@childrensmedical.e-mdsdirect.com
• Direct secure messaging: efairbank@cmg.opdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Childrens Medical Group

  • Pediatrics Physician
  • Hermitage, TN
  • NPI 1760456065
  NPD (past) Authorized official
• HCA Health Services of Tennessee, Inc.

  • General Acute Care Hospital
  • Hermitage, TN
  • NPI 1982650024
  NPD (past)

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268006400000",
    "number": "1316926876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3786 CENTRAL PIKE",
            "address_2": "# 130",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370763497",
            "telephone_number": "615-883-2200",
            "fax_number": "615-883-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3786 CENTRAL PIKE",
            "address_2": "# 130",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370763497",
            "telephone_number": "615-883-2200",
            "fax_number": "615-883-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANK",
        "first_name": "ELIZABETH",
        "middle_name": "HEATHER",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-12",
        "last_updated": "2010-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "034602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3898721",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Exquisite Krownz
• Anne E Eyler, MD
• Gilbert D Ezell, MD
• Meredith Ann Ezell, MD
• Matthew Fainer, PTA
• Oluyemi Bridget Falaiye, DMD
• Fall Fighters, LLC
• Amanda Sher Fallos, PA-C
• Bridget J Faloon, MS BCBA
• Family 1St Clinic

• Pediatrics Physician in Hermitage, TN
• Providers in Hermitage, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; 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.