NPIMap

Organization Active NPI

Deanna Elsea, M.D.

Doing business as Somerville Medical Clinic

  • Primary Care Clinic/Center
  • Somerville, TN
National Provider Identifier
1356436398
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
MD0000031550 Issued in TN
Legal business name
DEANNA ELSEA, M.D.
Doing business as
Somerville Medical Clinic
Practice address
213 Lakeview Rd
213 Lakeview Rd
Somerville, TN 38068-9744
Phone
(901) 465-5466
Fax
(901) 465-9048
NPI assigned
Oct 4, 2006
Last updated
Mar 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Authorized official

Name
Deanna S Elsea, INTERNAL MEDICINE
Title
Owner
Phone
(901) 465-5466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X MD0000031550 TN Primary

Addresses

Primary practice location

213 Lakeview Rd
213 Lakeview Rd
Somerville, TN 38068-9744

Mailing address

213 Lakeview Rd
213 Lakeview Rd
Somerville, TN 38068-9744
Phone (901) 465-5466

Other identifiers 1

IdentifierTypeStateIssuer
3733134MedicaidTN

Other names 1

  • SOMERVILLE MEDICAL CLINIC Doing business as

National Provider Directory

National Provider Directory

Locations

213 Lakeview Rd
Somerville, TN 38068
Phone (844) 727-2778

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1356436398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 LAKEVIEW RD",
            "address_2": "213 LAKEVIEW RD",
            "city": "SOMERVILLE",
            "state": "TN",
            "postal_code": "380689744",
            "telephone_number": "901-465-5466",
            "fax_number": "901-465-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 LAKEVIEW RD",
            "address_2": "213 LAKEVIEW RD",
            "city": "SOMERVILLE",
            "state": "TN",
            "postal_code": "380689744",
            "telephone_number": "901-465-5466",
            "fax_number": "901-465-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEANNA ELSEA, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "ELSEA",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-465-5466",
        "authorized_official_credential": "INTERNAL MEDICINE"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TN",
            "license": "MD0000031550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3733134",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOMERVILLE MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Somerville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.