NPIMap

Organization Active NPI

Jackson Endocrine and Diabetes Center PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Jackson, TN
National Provider Identifier
1538221551
Registry record updated May 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
JACKSON ENDOCRINE AND DIABETES CENTER PC
Practice address
110 E Forest Ave
Jackson, TN 38301-4124
Phone
(731) 421-8908
Fax
(731) 421-8469
NPI assigned
Dec 15, 2006
Last updated
May 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2013

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

Authorized official

Name
Ernest K Antwi, M.D.
Title
Owner
Phone
(731) 421-8908

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

110 E Forest Ave
Jackson, TN 38301-4124

Mailing address

PO Box 1798
Dept 07-028
Memphis, TN 38101-1798
Phone (731) 421-8908

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368403200000",
    "number": "1538221551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1798",
            "address_2": "DEPT 07-028",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381011798",
            "telephone_number": "731-421-8908",
            "fax_number": "731-421-8469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E FOREST AVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383014124",
            "telephone_number": "731-421-8908",
            "fax_number": "731-421-8469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON ENDOCRINE AND DIABETES CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2013-05-13",
        "status": "A",
        "authorized_official_last_name": "ANTWI",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-421-8908",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; 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.