Robert H Dunnebacke, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD011299 Issued in TN

Practice address

587 Skyline Dr
Jackson, TN 38301-3911

Phone

(731) 424-8922

Fax

(731) 423-2922

NPI assigned

Apr 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Internal Medicine Clinic of Jackson PLLC

  • Primary Care Clinic/Center
  • Jackson, TN
  • NPI 1174773428
  Authorized official Same address or phone
• The Medical Clinic of Jackson

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1043437130
  NPD
• West Tennessee Medical Group Inc

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1053615955
  NPD (past)

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629295738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "587 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013911",
            "telephone_number": "731-424-8922",
            "fax_number": "731-423-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013911",
            "telephone_number": "731-424-8922",
            "fax_number": "731-423-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNNEBACKE",
        "first_name": "ROBERT",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD011299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3182200",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shane Paul Dunaway, APN
• Kelly Michael Duncan, O D
• William Shannon Dunlap, DPH
• Chelsea Dunn
• Grace Dunn, LCSW
• Duo Services Inc (Comfort Keepers)
• Durham Chiropractic
• Joel W Durham, DC
• John W Duval, MD
• Elizabeth A Dye, PT

• Internal Medicine Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.