Individual provider Active NPI

Dewayne Paschall Darby, M.D.

  • Family Medicine Physician
  • Dandridge, TN
National Provider Identifier
1740203207
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD11040 Issued in TN
Practice address
150 W Price Rd
Dandridge, TN 37725-4524
Phone
(865) 475-6161
Fax
(865) 475-9857
NPI assigned
Jul 25, 2006
Last updated
Jan 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD11040 TN Primary

Addresses

Primary practice location

150 W Price Rd
Dandridge, TN 37725-4524

Mailing address

150 W Price Rd
Dandridge, TN 37725-4524
Phone (865) 475-6161

Other identifiers 4

IdentifierTypeStateIssuer
36328OtherBLUE CROSS BLUE SHIELD
TN0101OtherTNJOHN DEERE
3712179MedicaidTN
1505858MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dewayne.darby.1@3525.direct.athenahealth.com Direct

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11040TNMDDentist
MD11040TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Family Physicians P C Family Medicine PastSince Jul 8, 2005 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1740203207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W PRICE RD",
            "city": "DANDRIDGE",
            "state": "TN",
            "postal_code": "377254524",
            "telephone_number": "865-475-6161",
            "fax_number": "865-475-9857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W PRICE RD",
            "city": "DANDRIDGE",
            "state": "TN",
            "postal_code": "377254524",
            "telephone_number": "865-475-6161",
            "fax_number": "865-475-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARBY",
        "first_name": "DEWAYNE",
        "middle_name": "PASCHALL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD11040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "36328",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN0101",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3712179",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1505858",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dewayne.darby.1@3525.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "150 W Price Rd",
            "city": "Dandridge",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377254524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dandridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.