Active NPI
Joanie Wilson, RDH
- Dental Hygienist
- Elizabethton, TN
National Provider Identifier
1679021422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 5089
- Practice address
- 208 Parkway Blvd
Elizabethton, TN 37643-2845 - Phone
- (423) 543-5200
- Fax
- (423) 543-1499
- NPI assigned
- Sep 21, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 5089 | TN | Primary |
Addresses
Primary practice location
208 Parkway Blvd
Elizabethton, TN 37643-2845
Mailing address
103 Starlight Dr
Elizabethton, TN 37643-6145
Phone (423) 213-7789
Other names 1
- Joanie Morley
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 |
|---|---|---|---|
| 5089 | TN | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Elizabethton, TN
- NPI 1639804693
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474416000000",
"number": "1679021422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 STARLIGHT DR",
"city": "ELIZABETHTON",
"state": "TN",
"postal_code": "376436145",
"telephone_number": "423-213-7789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 PARKWAY BLVD",
"city": "ELIZABETHTON",
"state": "TN",
"postal_code": "376432845",
"telephone_number": "423-543-5200",
"fax_number": "423-543-1499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JOANIE",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-21",
"last_updated": "2016-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "TN",
"license": "5089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JOANIE",
"last_name": "MORLEY",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Elizabethton, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.