NPIMap

Organization Active NPI

Medical Education Assistance Corporation

  • Developmental - Behavioral Pediatrics Physician
  • Gray, TN
National Provider Identifier
1750650875
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
31588 Issued in TN
Legal business name
MEDICAL EDUCATION ASSISTANCE CORPORATION
Practice address
252 Sam Jenkins Rd
Attn: Dr. H. Patrick Stern
Gray, TN 37615
Phone
(423) 283-3060
Fax
(423) 283-7441
NPI assigned
Dec 19, 2011
Last updated
Aug 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X 31588 TN Primary

Addresses

Primary practice location

252 Sam Jenkins Rd
Attn: Dr. H. Patrick Stern
Gray, TN 37615

Mailing address

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

Other names 1

  • RIDGEVIEW ELEMENTRY Other name

National Provider Directory

National Provider Directory
Tax ID family
Dept of Path Lab-C E B27 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

252 Sam Jenkins Rd
#H
Gray, TN 37615
Phone (423) 283-3060

NPI Registry JSON

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1750650875",
    "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": "252 SAM JENKINS RD",
            "address_2": "ATTN: DR. H. PATRICK STERN",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "37615",
            "telephone_number": "423-283-3060",
            "fax_number": "423-283-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL EDUCATION ASSISTANCE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-19",
        "last_updated": "2018-08-22",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "TN",
            "license": "31588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RIDGEVIEW ELEMENTRY",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "RIDGEVIEW ELEMENTRY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gray, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.