NPIMap

Organization Active NPI

Johnson City Urological Clinic, P.C.

  • Pediatric Urology Physician
  • Johnson City, TN
National Provider Identifier
1578689253
Registry record updated Aug 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Urology PhysicianTaxonomy code 2088P0231X
Legal business name
JOHNSON CITY UROLOGICAL CLINIC, P.C.
Practice address
2340 Knob Creek Road
Suite 720
Johnson City, TN 37604-2977
Phone
(423) 926-6112
Fax
(423) 434-0278
NPI assigned
Mar 22, 2007
Last updated
Aug 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2009

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

Authorized official

Name
Grant D Taylor, M.D.NPI 1427013044
Title
Owner
Phone
(423) 926-6112

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
Pediatric Urology Physician 2088P0231X NU Primary

Addresses

Primary practice location

2340 Knob Creek Road
Suite 720
Johnson City, TN 37604-2977

Mailing address

2340 Knob Creek Road
Suite 720
Johnson City, TN 37604-2977
Phone (423) 926-6112

Other identifiers 1

IdentifierTypeStateIssuer
3172410MedicaidTN

National Provider Directory

National Provider Directory

Locations

350 Steeles Rd
#1
Bristol, TN 37620
Phone (423) 844-4925

2340 Knob Creek Rd
Ste 720
Johnson City, TN 37604
Phone (423) 926-6112

Interoperability endpoints

  • Direct secure messaging: ashleyskelton@jcuc.medalliesdirect.net
  • Direct secure messaging: cassieblackwell@jcuc.medalliesdirect.net
  • Direct secure messaging: chandragrubb@jcuc.medalliesdirect.net
  • Direct secure messaging: chrissymoses@jcuc.medalliesdirect.net
  • Direct secure messaging: davidbeaird@jcuc.medalliesdirect.net
  • Direct secure messaging: dextershepherd@jcuc.medalliesdirect.net
  • Direct secure messaging: granttaylor@jcuc.medalliesdirect.net
  • Direct secure messaging: jasonmccray@jcuc.medalliesdirect.net
  • Direct secure messaging: lincolnolsen@jcuc.medalliesdirect.net
  • Direct secure messaging: phillipstokes@jcuc.medalliesdirect.net
  • Direct secure messaging: waynetongco@jcuc.medalliesdirect.net
  • Direct secure messaging: williamrogers@jcuc.medalliesdirect.net

Practitioners & affiliated clinicians

Practitioners 8

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": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250640000000",
    "number": "1578689253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 KNOB CREEK ROAD",
            "address_2": "SUITE 720",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042977",
            "telephone_number": "423-926-6112",
            "fax_number": "423-434-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 KNOB CREEK ROAD",
            "address_2": "SUITE 720",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042977",
            "telephone_number": "423-926-6112",
            "fax_number": "423-434-0278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON CITY UROLOGICAL CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2009-08-19",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-926-6112",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3172410",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; 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.