Expedition Trails Emergency Physicians, LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

EXPEDITION TRAILS EMERGENCY PHYSICIANS, LLC

Practice address

4601 Medical Plaza Way
Clarksville, IN 47129-9204

Phone

(215) 442-5029

NPI assigned

Sep 9, 2013

Organization subpart

No

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

Authorized official

Name

Tenna K Behm

Title

VP of Enrollment

Phone

(469) 401-2386

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518134400000",
    "number": "1396170437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37922",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191010519",
            "telephone_number": "469-401-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 MEDICAL PLAZA WAY",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471299204",
            "telephone_number": "215-442-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPEDITION TRAILS EMERGENCY PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-09",
        "last_updated": "2018-02-09",
        "status": "A",
        "authorized_official_last_name": "BEHM",
        "authorized_official_first_name": "TENNA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "VP OF ENROLLMENT",
        "authorized_official_telephone_number": "469-401-2386"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Embrace Dental Care Clarksville
• Emmaus Catholic Counseling LLC
• Brady Ernest
• Montanna Etherton
• Kyla Everett, M.S.
• Ashley Nicole Faircloth, LMT
• Amy Diane Falkenstein, PMHNP
• Margaret Charlene Farris
• Mala S Feldman, HIS
• First Impressions Optometric Associates, LLC

• Emergency Medicine Physician in Clarksville, IN
• Providers in Clarksville, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2018; 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.