NPIMap

Organization Active NPI

Sertoma Center, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Knoxville, TN
National Provider Identifier
1437295292
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
L 3(20)4M6-056-1315 Issued in TN
Legal business name
SERTOMA CENTER, INC.
Practice address
1400 E 5TH Ave
Knoxville, TN 37917-7712
Phone
(865) 524-5555
Fax
(865) 524-5563
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Authorized official

Name
Ms. Rebecca D. Massey
Title
Executive Director
Phone
(865) 524-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X L 3(20)4M6-056-1315 TN Primary

Addresses

Primary practice location

1400 E 5TH Ave
Knoxville, TN 37917-7712

Mailing address

1400 E 5TH Ave
Knoxville, TN 37917-7712
Phone (865) 524-5555

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321833600000",
    "number": "1437295292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E 5TH AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379177712",
            "telephone_number": "865-524-5555",
            "fax_number": "865-524-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E 5TH AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379177712",
            "telephone_number": "865-524-5555",
            "fax_number": "865-524-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERTOMA CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2011-11-21",
        "status": "A",
        "authorized_official_last_name": "MASSEY",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "865-524-5555",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "TN",
            "license": "L 3(20)4M6-056-1315",
            "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 Nov 21, 2011; 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.