Active NPI
East Tennessee Medical Associates, P.C.
- Nephrology Physician
- Johnson City, TN
National Provider Identifier
1619089034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- MD6775
- Legal business name
- EAST TENNESSEE MEDICAL ASSOCIATES, P.C.
- Practice address
- 107 Woodlawn Dr
Johnson City, TN 37604-5978 - Phone
- (423) 929-7158
- Fax
- (423) 928-9625
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Melissa Ann Owens
- Title
- Practice Manager
- Phone
- (423) 929-7158
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | MD6775 | TN | Primary |
Addresses
Primary practice location
107 Woodlawn Dr
Johnson City, TN 37604-5978
Mailing address
107 Woodlawn Dr
Johnson City, TN 37604-6287
Phone (423) 929-7158
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0310587 | East Tennessee Medical Associates | Provider-performed microscopy | Jan 8, 2028 |
National Provider Directory
National Provider DirectoryLocations
107 Woodlawn Dr
Ste 200Q
Johnson City, TN 37604
100 Technology Ln
Johnson City, TN 37604
Phone (423) 929-7181
107 Woodlawn Dr
Ste 200
Johnson City, TN 37604
Phone (423) 929-7158
Practitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Johnson City, TN
- NPI 1326726449
-
- Nephrology Physician
- Johnson City, TN
- NPI 1700074416
-
- Nephrology Physician
- Johnson City, TN
- NPI 1376910208
-
- Nephrology Physician
- Johnson City, TN
- NPI 1407363989
-
- Nephrology Physician
- Johnson City, TN
- NPI 1720498777
-
- Nephrology Physician
- Johnson City, TN
- NPI 1851395891
-
- Nephrology Physician
- Johnson City, TN
- NPI 1295451482
-
- Nephrology Physician
- Johnson City, TN
- NPI 1487232484
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1787270400000",
"number": "1619089034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 WOODLAWN DR",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376046287",
"telephone_number": "423-929-7158",
"fax_number": "423-928-9625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 WOODLAWN DR",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376045978",
"telephone_number": "423-929-7158",
"fax_number": "423-928-9625"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EAST TENNESSEE MEDICAL ASSOCIATES, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-31",
"last_updated": "2026-08-21",
"certification_date": "2026-08-21",
"status": "A",
"authorized_official_last_name": "OWENS",
"authorized_official_first_name": "MELISSA",
"authorized_official_middle_name": "ANN",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "423-929-7158"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Nephrology",
"state": "TN",
"license": "MD6775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Johnson City, TN
- East Tennessee Family Care LLC
- East Tennessee Hearing Center
- East Tennessee Hematology-Oncology Assoc
- East Tennessee Hematology/Oncology Assoc P.C.
- East Tennessee Medical and Surgical Dermatology
- East Tennessee Neuropathy, PC
- East Tennessee Oncology Partners, LLC
- East Tennessee Recovery, PLLC
- East Tennessee Skilled Care
- East Tennessee State University
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.