Active NPI
Brittany M Cantrell, P.A.
- Medical Physician Assistant
- Johnson City, TN
National Provider Identifier
1497719322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA00911
- Practice address
- 1021 W Oakland Ave
Suite 301
Johnson City, TN 37604-2191 - Phone
- (423) 952-8000
- Fax
- (423) 952-8001
- NPI assigned
- Apr 17, 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA00911 | TN | Primary |
Addresses
Primary practice location
1021 W Oakland Ave
Suite 301
Johnson City, TN 37604-2191
Mailing address
1021 W Oakland Ave
Suite 301
Johnson City, TN 37604-2191
Phone (423) 952-8000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4043132 | Other | TN | BCBS |
| TN01Q4 | Other | TN | JOHN DEERE |
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 |
|---|---|---|---|
| PA00911 | TN | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497719322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 W OAKLAND AVE",
"address_2": "SUITE 301",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042191",
"telephone_number": "423-952-8000",
"fax_number": "423-952-8001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1021 W OAKLAND AVE",
"address_2": "SUITE 301",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042191",
"telephone_number": "423-952-8000",
"fax_number": "423-952-8001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANTRELL",
"first_name": "BRITTANY",
"middle_name": "M",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TN",
"license": "PA00911",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4043132",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "TN01Q4",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Johnson City, TN
- Cancer Outreach Associates of Tennessee, P.C.
- Benjamin Chad Cannon, CPRS
- Cathlyn Carole Cannon, L.P.C. MHSP
- Elizabeth Forgey Cannon, DDS
- Jennifer Leigh Cannon, FNP
- McKayla Cantrell, CCC-SLP
- Peggy Joyce Cantrell
- Peter M Caravello, MD
- Thatcher Lee Card, MSN, APRN, FNP -C
- Samantha J. Carder-Lancaster, PHARM.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.