Active NPI
Jeffrey Scott Queen, MD
- Pediatric Anesthesiology Physician
- Knoxville, TN
National Provider Identifier
1386655470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Anesthesiology Physician
- License
- 20163
- Practice address
- 2018 Clinch Avenue
Knoxville, TN 37916-2301 - Phone
- (865) 541-8485
- Fax
- (865) 541-8727
- NPI assigned
- Aug 11, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Anesthesiology Physician | 207LP3000X | 20163 | TN | Primary |
Addresses
Primary practice location
2018 Clinch Avenue
Knoxville, TN 37916-2301
Mailing address
PO Box 15010
Knoxville, TN 37901-5010
Phone (865) 541-8485
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3028710 | Other | TN | BLUECARE |
| 3028710 | Other | TN | TENNCARE SELECT |
| 64798606 | Medicaid | KY | |
| 3058413 | Medicaid | TN | |
| 3028710 | Other | TN | BLUE CROSS BLUE SHIELD |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20163 | TN | MD | Pediatric Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386655470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 15010",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379015010",
"telephone_number": "865-541-8485",
"fax_number": "865-541-8727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2018 CLINCH AVENUE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379162301",
"telephone_number": "865-541-8485",
"fax_number": "865-541-8727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUEEN",
"first_name": "JEFFREY",
"middle_name": "SCOTT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207LP3000X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": "TN",
"license": "20163",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECARE",
"identifier": "3028710",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TENNCARE SELECT",
"identifier": "3028710",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64798606",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3058413",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "3028710",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.