Organization Active NPI

Dea, MD, PC

  • Internal Medicine Physician
  • Oak Ridge, TN
National Provider Identifier
1578370409
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DEA, MD, PC
Doing business as
Dea, MD, PC
Practice address
138 Fairbanks Rd
Oak Ridge, TN 37830-7077
Phone
(931) 248-1414
Fax
(931) 707-5178
NPI assigned
Dec 13, 2024
Last updated
Dec 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Authorized official

Name
Derron E Allen, MDNPI 1902078041
Title
Owner
Phone
(615) 479-0743

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

138 Fairbanks Rd
Oak Ridge, TN 37830-7077

Mailing address

PO Box 3350
Crossville, TN 38557-3350
Phone (931) 248-1414

Other names 1

  • DEA, MD, PC Doing business as

National Provider Directory

National Provider Directory

Locations

138 Fairbanks Rd
Oak Ridge, TN 37830
Phone (931) 248-1414

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1734048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1578370409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3350",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385573350",
            "telephone_number": "931-248-1414",
            "fax_number": "931-707-5178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 FAIRBANKS RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378307077",
            "telephone_number": "931-248-1414",
            "fax_number": "931-707-5178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEA, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-13",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "DERRON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-479-0743",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEA, MD, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.