NPIMap

Organization Active NPI

Gregory H Pastrick PC

Doing business as DBA The Plastic Surgery Center of East Tennessee

  • Plastic Surgery Physician
  • Kingsport, TN
National Provider Identifier
1336165703
Registry record updated Dec 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
31934 Issued in TN
Legal business name
GREGORY H PASTRICK PC
Doing business as
DBA The Plastic Surgery Center of East Tennessee
Practice address
1 Sheridan SQ
Suite 200
Kingsport, TN 37660-7393
Phone
(423) 392-4884
Fax
(423) 392-4820
NPI assigned
Jul 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2008

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

Authorized official

Name
Mrs. Christine M Pastrick, R.N.
Title
Office Administrator
Phone
(423) 392-4878

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 31934 TN Primary

Addresses

Primary practice location

1 Sheridan SQ
Suite 200
Kingsport, TN 37660-7393

Mailing address

1 Sheridan SQ
Suite 200
Kingsport, TN 37660-7393
Phone (423) 392-4884

Other identifiers 1

IdentifierTypeStateIssuer
4046491OtherTNBLUE CROSS BLUE SHIELD

Other names 1

  • DBA The Plastic Surgery Center of East Tennessee Doing business as

National Provider Directory

National Provider Directory

Locations

1 Sheridan Sq
Ste 200
Kingsport, TN 37660
Phone (423) 247-2252

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228953600000",
    "number": "1336165703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SHERIDAN SQ",
            "address_2": "SUITE 200",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607393",
            "telephone_number": "423-392-4884",
            "fax_number": "423-392-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHERIDAN SQ",
            "address_2": "SUITE 200",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607393",
            "telephone_number": "423-392-4884",
            "fax_number": "423-392-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY H PASTRICK PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2008-12-11",
        "status": "A",
        "authorized_official_last_name": "PASTRICK",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "423-392-4878",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "TN",
            "license": "31934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4046491",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA The Plastic Surgery Center of East Tennessee",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; 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.