Organization Active NPI

Southeast Tennessee Orthopaedics, Inc

  • Orthopaedic Surgery Physician
  • Cleveland, TN
National Provider Identifier
1538175336
Registry record updated Dec 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD15518 Issued in TN
Legal business name
SOUTHEAST TENNESSEE ORTHOPAEDICS, INC
Practice address
102 Dunhill PL NW
Cleveland, TN 37311-3883
Phone
(423) 472-1567
NPI assigned
Aug 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2010

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

Authorized official

Name
Daniel V. Johnson, M.D.
Title
Partner
Phone
(423) 472-1567

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207X00000X MD15518 TN Primary

Addresses

Primary practice location

102 Dunhill PL NW
Cleveland, TN 37311-3883

Mailing address

102 Dunhill Place NW
Cleveland, TN 37311-3883
Phone (423) 472-1567

Other identifiers 2

IdentifierTypeStateIssuer
1083658496OtherNPI STONE
1427094747OtherNPI JOHNSON

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293408000000",
    "number": "1538175336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 DUNHILL PLACE NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113883",
            "telephone_number": "423-472-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 DUNHILL PL NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113883",
            "telephone_number": "423-472-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST TENNESSEE ORTHOPAEDICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2010-12-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "423-472-1567",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "MD15518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI STONE",
            "identifier": "1083658496",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI JOHNSON",
            "identifier": "1427094747",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; 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.