Individual provider Active NPI

Elizabeth Daubner, MD

  • Family Medicine Physician
  • Cleveland, TN
National Provider Identifier
1366441990
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17474 Issued in TN
Practice address
201 Dooley St SE
Cleveland, TN 37311-6220
Phone
(423) 728-7020
NPI assigned
Jul 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 17474 TN Primary

Addresses

Primary practice location

201 Dooley St SE
Cleveland, TN 37311-6220

Mailing address

201 Dooley St SE
Cleveland, TN 37311-6220
Phone (423) 728-7020

Other identifiers 3

IdentifierTypeStateIssuer
3023722MedicaidTN
3152700OtherTNBCBS
4248967OtherTNBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17474TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Urgent Care PLLC Family Medicine Past Accepting new patients
Cleveland Medical Clinic Inc Family Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1366441990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DOOLEY ST SE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373116220",
            "telephone_number": "423-728-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 DOOLEY ST SE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373116220",
            "telephone_number": "423-728-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUBNER",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "17474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3023722",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3152700",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4248967",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.