Active NPI
Tennessee Breast Center, Inc
- Diagnostic Radiology Physician
- Maryville, TN
National Provider Identifier
1376759852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 0234636
- Legal business name
- TENNESSEE BREAST CENTER, INC
- Practice address
- 1111 E Lamar Alexander Pkwy
Maryville, TN 37804-5130 - Phone
- (865) 984-9282
- Fax
- (865) 981-1716
- NPI assigned
- May 14, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Melissa E Trekell, M.D.,FACS, M.B.A.
- Title
- President
- Phone
- (856) 984-9282
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 0234636 | TN | Primary |
Addresses
Primary practice location
1111 E Lamar Alexander Pkwy
Maryville, TN 37804-5130
Mailing address
1111 E Lamar Alexander Pkwy
Maryville, TN 37804-5130
Phone (865) 984-9282
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3730971 | Medicaid | TN |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1376759852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 E LAMAR ALEXANDER PKWY",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378045130",
"telephone_number": "865-984-9282",
"fax_number": "865-981-1716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 E LAMAR ALEXANDER PKWY",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378045130",
"telephone_number": "865-984-9282",
"fax_number": "865-981-1716"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TENNESSEE BREAST CENTER, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-14",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "TREKELL",
"authorized_official_first_name": "MELISSA",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "856-984-9282",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D.,FACS, M.B.A."
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": "TN",
"license": "0234636",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3730971",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Maryville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.