Lifescan Tennessee, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

ODC0000000042 Issued in TN

Legal business name

LIFESCAN TENNESSEE, LLC

Doing business as

Molecular Imaging Alliance of Tennessee

Practice address

830 Suncrest Dr
Unit 2
Gray, TN 37615-3424

Phone

(423) 477-3026

Fax

(423) 477-2686

NPI assigned

Oct 4, 2007

Last updated

Sep 20, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert Gregory

Title

President

Phone

(423) 477-3026

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Molecular Imaging Alliance of Tennessee Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Blue Ridge Medical Management Corporation

  dba Ballad Health Medical Associates

  • Internal Medicine Physician
  • Marion, VA
  • NPI 1528407996

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379635200000",
    "number": "1386832368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N STATE OF FRANKLIN RD",
            "address_2": "SUITE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043645",
            "telephone_number": "423-477-3026",
            "fax_number": "423-477-2686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 SUNCREST DR",
            "address_2": "UNIT 2",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376153424",
            "telephone_number": "423-477-3026",
            "fax_number": "423-477-2686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESCAN TENNESSEE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2013-09-20",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-477-3026",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "TN",
            "license": "ODC0000000042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3790000",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Molecular Imaging Alliance of Tennessee",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Lamon
• Linda Susan Latimer, MD
• Melissa V Layne, NP
• Grace K Leeman
• Jacob William Lewis-Jones, FNP-BC
• Little Blessings ABA, PLLC
• Daniel Lee Marshall, BSS
• Elizabeth McFarland, MS, LPC/MHSP
• Leslie Anne Lowe Meade, BSW
• Medical Education Assistance Corporation

• Radiology Clinic/Center in Gray, TN
• Providers in Gray, TN by specialty
• Radiology Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.