Individual provider Active NPI

William Russell May Jr., DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Cleveland, TN
National Provider Identifier
1578798666
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
10161 Issued in TN
Practice address
2253 Chambliss Ave NW
Suite 403
Cleveland, TN 37311-3861
Phone
(423) 709-0400
Fax
(423) 709-0401
NPI assigned
May 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 10161 TN Primary

Addresses

Primary practice location

2253 Chambliss Ave NW
Suite 403
Cleveland, TN 37311-3861

Mailing address

1505 E Lamar Alexander Pkwy
Maryville, TN 37804-5131
Phone (865) 983-8630

Other identifiers 1

IdentifierTypeStateIssuer
10161OtherTNDENTAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151202000800 TN Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 3072813740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
University of Alabama School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Tennessee Oral and Maxillofacial Surgery, PCGroup PAC ID 9234103359, 5 clinicians

Practice addresses (Care Compare)

1505 E Lamar Alexander Pkwy
Maryville, TN 37804-5131
Phone (865) 983-8630

307 Maple St
Athens, TN 37303-2957
Phone (423) 745-8708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10161TNMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Oral & Maxillofacial Surgery, PC Oral and Maxillofacial Surgery CurrentSince Jan 1, 2016 Accepting new patients
East Tennessee Oral & Maxillofacial Surgery, PC Oral and Maxillofacial Surgery CurrentSince Jan 1, 2016 Accepting new patients

Locations

307 Maple St
Athens, TN 37303
Phone (423) 744-7585

126 Stuart Xing NE
Cleveland, TN 37312
Phone (423) 709-0400

2253 Chambliss Ave NW
Ste 403
Cleveland, TN 37311
Phone (423) 380-0546

1505 E Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 983-8630

700 S Illinois Ave
Ste A104
Oak Ridge, TN 37830
Phone (865) 383-0737

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1578798666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045131",
            "telephone_number": "865-983-8630",
            "fax_number": "865-981-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2253 CHAMBLISS AVE NW",
            "address_2": "SUITE 403",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113861",
            "telephone_number": "423-709-0400",
            "fax_number": "423-709-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAY",
        "first_name": "WILLIAM",
        "middle_name": "RUSSELL",
        "name_suffix": "Jr.",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-19",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "10161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "10161",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.