NPIMap

Organization Active NPI

Medical Education Assistance Corporation

  • Obstetrics & Gynecology Physician
  • Johnson City, TN
National Provider Identifier
1679842637
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD40130 Issued in TN
Legal business name
MEDICAL EDUCATION ASSISTANCE CORPORATION
Practice address
325 N State of Franklin Rd
Johnson City, TN 37604
Phone
(423) 433-6050
Fax
(423) 433-6060
NPI assigned
Dec 21, 2011
Last updated
Sep 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Authorized official

Name
Russell E Lewis
Title
Executive Director
Phone
(423) 433-6050

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MD19201 TN
Internal Medicine Physician 207R00000X MD19625 TN
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD26210 TN
Infectious Disease Physician 207RI0200X MD39380 TN
Obstetrics & Gynecology Physician 207V00000X MD40130 TN Primary
Maternal & Fetal Medicine Physician 207VM0101X MD13109 TN
Ophthalmology Physician 207W00000X MD12599 TN
Pediatrics Physician 208000000X MD45960 TN
Pediatric Adolescent Medicine Physician 2080A0000X MD35095 TN
Pediatric Cardiology Physician 2080P0202X MD34692 TN
Pediatric Infectious Diseases Physician 2080P0208X MD43116 TN
Pediatric Nephrology Physician 2080P0210X MD20802 TN
Pediatric Pulmonology Physician 2080P0214X MD16312 TN
Plastic Surgery Physician 208200000X MD25709 TN
Surgery Physician 208600000X MD20468 TN

Addresses

Primary practice location

325 N State of Franklin Rd
Johnson City, TN 37604

Mailing address

PO Box 2204
Johnson City, TN 37605-2204
Phone (423) 433-6050

Other names 1

  • CEB I Other name

National Provider Directory

National Provider Directory
Tax ID family
George Testerman MD27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Locations

325 N State of Franklin Rd
#G
Johnson City, TN 37604

325 N State of Franklin Rd
Fl 1
Johnson City, TN 37604
Phone (423) 439-7272

325 N State of Franklin Rd
Fl 2
Johnson City, TN 37604
Phone (423) 439-7280

Practitioners & affiliated clinicians

Practitioners 86

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 86

NPI Registry JSON

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

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568160000000",
    "number": "1679842637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2204",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376052204",
            "telephone_number": "423-433-6050",
            "fax_number": "423-433-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-433-6050",
            "fax_number": "423-433-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL EDUCATION ASSISTANCE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-21",
        "last_updated": "2019-09-11",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "423-433-6050"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "TN",
            "license": "MD19201",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD19625",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TN",
            "license": "MD26210",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TN",
            "license": "MD39380",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "MD40130",
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "TN",
            "license": "MD13109",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "MD12599",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD45960",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "TN",
            "license": "MD35095",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TN",
            "license": "MD34692",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "TN",
            "license": "MD43116",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "TN",
            "license": "MD20802",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "TN",
            "license": "MD16312",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TN",
            "license": "MD25709",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD20468",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CEB I",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CEB I",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.