Active NPI
Alan Charles Queen, LMT
- Mechanotherapist
- Erwin, TN
National Provider Identifier
1598997124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- 7561
- Practice address
- 104 S Main Ave
Erwin, TN 37650-1238 - Phone
- (423) 388-8940
- NPI assigned
- Aug 15, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | 7561 | TN | Primary |
Addresses
Primary practice location
104 S Main Ave
Erwin, TN 37650-1238
Mailing address
104 S Main Ave
Erwin, TN 37650-1238
Phone (423) 388-8940
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7561 | TN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250294400000",
"number": "1598997124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 S MAIN AVE",
"city": "ERWIN",
"state": "TN",
"postal_code": "376501238",
"telephone_number": "423-388-8940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 S MAIN AVE",
"city": "ERWIN",
"state": "TN",
"postal_code": "376501238",
"telephone_number": "423-388-8940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUEEN",
"first_name": "ALAN",
"middle_name": "CHARLES",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-15",
"last_updated": "2009-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "TN",
"license": "7561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erwin, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.