NPIMap

Organization Active NPI

Dermatology Assoc.of Oak Ridge,PC

  • Nurse Practitioner
  • Oak Ridge, TN
National Provider Identifier
1710145537
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN0000013542 Issued in TN
Legal business name
DERMATOLOGY ASSOC.OF OAK RIDGE,PC
Practice address
800 Oak Ridge Tpke
Suite a-300
Oak Ridge, TN 37830-6957
Phone
(865) 813-1009
Fax
(865) 482-4036
NPI assigned
May 29, 2008
Last updated
Aug 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Authorized official

Name
Ms. Jerry A Allen, APN-CNPI 1285884429
Title
Apn-C
Phone
(865) 813-1009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X APN0000013542 TN Primary

Addresses

Primary practice location

800 Oak Ridge Tpke
Suite a-300
Oak Ridge, TN 37830-6957

Mailing address

800 Oak Ridge Tpke
Suite a-300
Oak Ridge, TN 37830-6957
Phone (865) 813-1009

Other identifiers 2

IdentifierTypeStateIssuer
APN0000013542OtherTNCERTIFIED ADVANCED PRACTICE NURSE LICENSE
208001120OtherTNANCC CERTIFICATE FOR FNP

National Provider Directory

National Provider Directory

Locations

800 Oak Ridge Tpke
Ste A300
Oak Ridge, TN 37830
Phone (865) 482-2129

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1710145537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 OAK RIDGE TPKE",
            "address_2": "SUITE A-300",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306957",
            "telephone_number": "865-813-1009",
            "fax_number": "865-482-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 OAK RIDGE TPKE",
            "address_2": "SUITE A-300",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306957",
            "telephone_number": "865-813-1009",
            "fax_number": "865-482-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOC.OF OAK RIDGE,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "APN-C",
        "authorized_official_telephone_number": "865-813-1009",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APN-C"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN0000013542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED ADVANCED PRACTICE NURSE LICENSE",
            "identifier": "APN0000013542",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC CERTIFICATE FOR FNP",
            "identifier": "208001120",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.