Cynthia J Easter, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

41505 Issued in TN

Practice address

641 Morganton Square Dr
Maryville, TN 37801-4763

Phone

(865) 724-1590

Fax

(865) 724-1591

NPI assigned

Jan 15, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Cynthia Wallace Former name

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 and National Provider Directory roles.

• Cynthia J Easter MD LLC

  • Medical Specialty Clinic/Center
  • Maryville, TN
  • NPI 1295350775
  NPD Authorized official
• Bright Star Child and Adolescent Psychiatry LLC

  • Pediatrics Physician
  • Maryville, TN
  • NPI 1609424274
  NPD (past)
• Cherokee Health Systems

  dba River Valley Health

  • Federally Qualified Health Center (FQHC)
  • Talbott, TN
  • NPI 1134128820

  Single Specialty

  NPD (past)
• Prisma Health - Blount Memorial Hospital Inc.

  dba Blount Memorial Hospital

  • General Acute Care Hospital
  • Maryville, TN
  • NPI 1619939071

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1659422053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 MORGANTON SQUARE DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014763",
            "telephone_number": "865-724-1590",
            "fax_number": "865-724-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 MORGANTON SQUARE DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014763",
            "telephone_number": "865-724-1590",
            "fax_number": "865-724-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTER",
        "first_name": "CYNTHIA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD41505",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "41505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3833711",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "WALLACE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• East Tennessee Clinic of Chiropractic
• East Tennessee Dialysis Center Inc
• East Tennessee Foot Clinic PC
• East Tennessee Oral & Maxillofacial Surgery, PC
• East Tennessee Senior Care (Home Instead)
• Easterly Family Medicine
• Jeffery Easterly, MD
• Jeffrey Jennings Eberting, D.M.D.
• Edc Chiropractic Inc. (Watts Chiropractic)
• Bethany Edmond

• Pediatrics Physician in Maryville, TN
• Providers in Maryville, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; 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.