Loudon County Pediatrics, PC

Primary specialty

Pediatric Clinical Nurse SpecialistTaxonomy code 364SP0200X

License

145961 Issued in TN

Legal business name

LOUDON COUNTY PEDIATRICS, PC

Practice address

423 Medical Park Dr
Lenoir City, TN 37772-5640

Phone

(865) 986-9233

Fax

(865) 986-0148

NPI assigned

May 6, 2010

Organization subpart

No

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

Authorized official

Name

Dwight Daniel Bivens

Title

Secretary/Treasurer

Phone

(865) 986-9233

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273104000000",
    "number": "1578881132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 MEDICAL PARK DR",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377725640",
            "telephone_number": "865-986-9233",
            "fax_number": "865-986-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 MEDICAL PARK DR",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377725640",
            "telephone_number": "865-986-9233",
            "fax_number": "865-986-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUDON COUNTY PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-06",
        "last_updated": "2010-05-06",
        "status": "A",
        "authorized_official_last_name": "BIVENS",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "865-986-9233"
    },
    "taxonomies": [
        {
            "code": "364SP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "TN",
            "license": "145961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1841514155",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1265462287",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lincare Inc.
• Livewell Pharmacy LLC
• George Michael Lodeiro, MD
• Kimberly Lokey
• Loudon Cardiology, PLLC
• Loudon Dermatology, P.C.
• Matthew David Lowrance, DO
• Mary Helen Lyle-Joiner, LPC-MHSP
• June Yvonne Lyons, DO
• Mabry Family Dentistry

• Pediatric Clinical Nurse Specialist in Lenoir City, TN
• Providers in Lenoir City, TN by specialty
• Pediatric Clinical Nurse Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.