Active NPI
Shirley Bannister Avery, MD
- Allergy & Immunology Physician
- Knoxville, TN
National Provider Identifier
1396017018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- MD4658
- Practice address
- 822 Westborough Rd
Knoxville, TN 37909 - Phone
- (865) 693-0875
- NPI assigned
- Jan 27, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | MD4658 | TN | Primary |
Addresses
Primary practice location
822 Westborough Rd
Knoxville, TN 37909
Mailing address
822 Westborough Rd
Knoxville, TN 37909
Phone (865) 693-0875
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 |
|---|---|---|---|
| MD4658 | TN | MD | Allergy & Immunology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327622400000",
"number": "1396017018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "822 WESTBOROUGH RD",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "37909",
"telephone_number": "865-693-0875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "822 WESTBOROUGH RD",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "37909",
"telephone_number": "865-693-0875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVERY",
"first_name": "SHIRLEY",
"middle_name": "BANNISTER",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-27",
"last_updated": "2012-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "TN",
"license": "MD4658",
"primary": true
}
],
"identifiers": [],
"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 Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.