NPIMap

Organization Active NPI

Medical Education Assistance Corporation

Doing business as ETSU Quillen Fertility and Women's Services

  • Clinical Medical Laboratory
  • Johnson City, TN
National Provider Identifier
1336408996
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
4210 Issued in TN
Legal business name
MEDICAL EDUCATION ASSISTANCE CORPORATION
Doing business as
ETSU Quillen Fertility and Women's Services
Practice address
1319 Sunset Dr Ste 103
Johnson City, TN 37604
Phone
(423) 439-7246
Fax
(423) 282-4698
NPI assigned
May 16, 2012
Last updated
Aug 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Authorized official

Name
Mr. Russell E Lewis
Title
Executive Director
Phone
(423) 433-6050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 4210 TN Primary

Addresses

Primary practice location

1319 Sunset Dr Ste 103
Johnson City, TN 37604

Mailing address

PO Box 699
Mountain Home, TN 37684-0699
Phone (423) 433-6050

Other identifiers 1

IdentifierTypeStateIssuer
1235200676OtherTNLAB GROUP NPI

Other names 1

  • ETSU Quillen Fertility and Women's Services Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2004551Medical Education Assistance Corporation1319 Sunset Drive, Suite 103, Johnson City, TN 37604ComplianceMar 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
George Testerman MD27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1336408996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-433-6050",
            "fax_number": "423-433-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 SUNSET DR STE 103",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-439-7246",
            "fax_number": "423-282-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL EDUCATION ASSISTANCE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-16",
        "last_updated": "2018-08-22",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "423-433-6050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TN",
            "license": "4210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LAB GROUP NPI",
            "identifier": "1235200676",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ETSU Quillen Fertility and Women's Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ETSU Quillen Fertility and Women's Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.