Active NPI
Leeann Fairall, PA-C
- Physician Assistant
- Alcoa, TN
National Provider Identifier
1396814695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 156
- Practice address
- 266 Joule St
Alcoa, TN 37701-2422 - Phone
- (865) 984-3864
- Fax
- (865) 380-2131
- NPI assigned
- Nov 8, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 156 | TN | Primary |
Addresses
Primary practice location
266 Joule St
Alcoa, TN 37701-2422
Mailing address
PO Box 5358
Maryville, TN 37802-5358
Phone (865) 681-9148
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 156 | TN | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199318400000",
"number": "1396814695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5358",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378025358",
"telephone_number": "865-681-9148",
"fax_number": "865-380-2131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "266 JOULE ST",
"city": "ALCOA",
"state": "TN",
"postal_code": "377012422",
"telephone_number": "865-984-3864",
"fax_number": "865-380-2131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRALL",
"first_name": "LEEANN",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2008-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alcoa, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.