Individual provider Active NPI

Christine N Dalton, NP

  • Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1366761272
Registry record updated May 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
158754 Issued in TN
Practice address
200 Med Tech Pkwy
Suite 108
Johnson City, TN 37604-2278
Phone
(423) 915-5033
Fax
(423) 915-5179
NPI assigned
May 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 158754 TN Primary

Addresses

Primary practice location

200 Med Tech Pkwy
Suite 108
Johnson City, TN 37604-2278

Mailing address

200 Med Tech Pkwy
Suite 108
Johnson City, TN 37604-2278
Phone (423) 915-5033

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
158754TNMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274313600000",
    "number": "1366761272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MED TECH PKWY",
            "address_2": "SUITE 108",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042278",
            "telephone_number": "423-915-5033",
            "fax_number": "423-915-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MED TECH PKWY",
            "address_2": "SUITE 108",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042278",
            "telephone_number": "423-915-5033",
            "fax_number": "423-915-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALTON",
        "first_name": "CHRISTINE",
        "middle_name": "N",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-18",
        "last_updated": "2010-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "158754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 20, 2010; 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.