East Tennessee Urologic Associates

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

EAST TENNESSEE UROLOGIC ASSOCIATES

Practice address

508 Princeton Rd
Suite 104
Johnson City, TN 37601-2060

Phone

(423) 928-0168

Fax

(423) 928-5141

NPI assigned

May 10, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Kay D Jones

Title

Office Manager

Phone

(423) 928-0168

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710936257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 PRINCETON RD",
            "address_2": "SUITE 104",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012060",
            "telephone_number": "423-928-0168",
            "fax_number": "423-928-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 PRINCETON RD",
            "address_2": "SUITE 104",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012060",
            "telephone_number": "423-928-0168",
            "fax_number": "423-928-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TENNESSEE UROLOGIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KAY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "423-928-0168",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3382693",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CF2875",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Tennessee State University (Johnson City Community Health Center)
• East Tennessee State University (Children's First)
• East Tennessee State University (Student University Health Services)
• East Tennessee State University (ETSU High Risk Clinic)
• East Tennessee State University (JCDC/JCHA Partners for Health)
• Richard Lee Easter, PT, DPT, OCS
• Keely Page Easterling, MA
• Abigail Eastham, MD
• Laura Green Eaton, FNP
• Celso T Ebeo, M.D.

• Urology Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Urology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.