NPIMap

Organization Active NPI

Medical Education Assistance Corporation

  • Family Medicine Physician
  • Bristol, TN
National Provider Identifier
1710009907
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL EDUCATION ASSISTANCE CORPORATION
Practice address
208 Medical Park Blvd
Bristol, TN 37620
Phone
(423) 989-4050
Fax
(423) 990-3044
NPI assigned
Apr 6, 2007
Organization subpart
Yes
Parent organization
MEDICAL EDUCATION ASSISTANCE CORPORATION D.B.A. ETSU PHYSICIANS & ASSOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

208 Medical Park Blvd
Bristol, TN 37620

Mailing address

PO Box 699
Mountain Home, TN 37684-0699
Phone (423) 433-6039

Other names 1

  • UNIVERSITY PHYSICIANS PRACTICE GROUP-ETSU FAMILY MEDICINE BRISTOL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Univ Phy Prac Group27 organizations share this tax ID, including this one
Part of
Univ Phy Prac Group

Other organizations with this tax ID 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1710009907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-433-6039",
            "fax_number": "423-433-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 MEDICAL PARK BLVD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "37620",
            "telephone_number": "423-989-4050",
            "fax_number": "423-990-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL EDUCATION ASSISTANCE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL EDUCATION ASSISTANCE CORPORATION D.B.A. ETSU PHYSICIANS & ASSO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2023-03-07",
        "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": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UNIVERSITY PHYSICIANS PRACTICE GROUP-ETSU FAMILY MEDICINE BRISTOL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UNIVERSITY PHYSICIANS PRACTICE GROUP-ETSU FAMILY MEDICINE BRISTOL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.