Brian Lee Villanueva, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD0000040334 Issued in TN

Practice address

304 Wright St
Sweetwater, TN 37874-1181

Phone

(865) 213-8593

Fax

(865) 213-8593

NPI assigned

Oct 3, 2007

Sex

Male

Sole proprietor

Yes

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

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Surgical Services P.C.

  • Surgery Physician
  • Sweetwater, TN
  • NPI 1154433886

  Surgery

  NPD (past)

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256774400000",
    "number": "1659568608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 AUTUMN WOODS DRIVE",
            "city": "SWEETWATER",
            "state": "TN",
            "postal_code": "37874",
            "telephone_number": "423-351-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 WRIGHT ST",
            "city": "SWEETWATER",
            "state": "TN",
            "postal_code": "378741181",
            "telephone_number": "865-213-8593",
            "fax_number": "865-213-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "BRIAN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-03",
        "last_updated": "2009-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD0000040334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD0000040334",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terri Lee Tucker, MS., CCC-SLP
• Amanda Tuscan, PTA
• Ut Lifestar, LLC
• Thomas Vance, NP
• Bridgette Vestal, PHARMD
• Ramon Villanueva, M.D.
• Chloe Ann Vincil, LPC-MHSP, NCC
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co

• Surgery Physician in Sweetwater, TN
• Providers in Sweetwater, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.