Bethany Ann Doles
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Harrogate, TN
NPI 1376247015 · NPPES record last updated Mar 28, 2023
Key facts
- NPI
- 1376247015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 6965 Cumberland Gap Pkwy
Harrogate, TN 37752-8245 - Phone
- (423) 869-7200
- NPI assigned
- Mar 28, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240715001783 | MI | Order and Referring Only - General Surgery |
3173068160 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
6965 Cumberland Gap Pkwy
Harrogate, TN 37752-8245
Mailing address
6965 Cumberland Gap Pkwy
Harrogate, TN 37752-8245
Other providers in Harrogate, TN
- Luke Anthony Cooper
- Ellen Cottrell
- Cumberland Gap Orthodontics
- Cumberland Gap Transport
- Mariela Chantel Davis
- Family Medical Clinic of Harrogate, P.C.
- Lexi Fleming
- Megan Ford
- Christopher Fraley
- Emilie Francois
All providers in Harrogate, TN · Student in an Organized Health Care Education/Training Program in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.