NPIMap

Organization Active NPI

Medical Education Assistance Corporation University Physicians Practic

  • Clinical Medical Laboratory
  • Mountain Home, TN
National Provider Identifier
1346340767
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
2082 Issued in TN
Legal business name
MEDICAL EDUCATION ASSISTANCE CORPORATION UNIVERSITY PHYSICIANS PRACTIC
Practice address
Dogwood Lane
BLDG 119
Mountain Home, TN 37684
Phone
(423) 439-6242
NPI assigned
Sep 25, 2006
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 2082 TN Primary

Addresses

Primary practice location

Dogwood Lane
BLDG 119
Mountain Home, TN 37684

Mailing address

PO Box 699
Mountain Home, TN 37684-0699
Phone (423) 433-6054

Other identifiers 1

IdentifierTypeStateIssuer
1235200676OtherLABS GROUP NPI

Other names 1

  • CLINICAL MICROBIOLOGY LABORATORY Other name

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1346340767",
    "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": "423-433-6054",
            "fax_number": "423-433-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DOGWOOD LANE",
            "address_2": "BLDG 119",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "37684",
            "telephone_number": "423-439-6242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL EDUCATION ASSISTANCE CORPORATION UNIVERSITY PHYSICIANS PRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "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": "2082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABS GROUP NPI",
            "identifier": "1235200676",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINICAL MICROBIOLOGY LABORATORY",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CLINICAL MICROBIOLOGY LABORATORY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mountain Home, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.