MSP Boone Clinic, PLLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

MSP BOONE CLINIC, PLLC

Practice address

610 State Farm Rd Ste C
Boone, NC 28607-4713

Phone

(828) 265-3668

Fax

(828) 265-4417

NPI assigned

Oct 20, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan D Tenley, DPMNPI 1154881506

Title

Owner

Phone

(828) 265-3668

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Tax ID family

MSP Boone Clinic PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• MSP Boone Clinic, PLLC

  • Primary Podiatric Medicine Podiatrist
  • Jefferson, NC
  • NPI 1013782804
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jonathan David Tenley, DPM

  • Foot & Ankle Surgery Podiatrist
  • Morganton, NC
  • NPI 1154881506

  Single Specialty

  Medicare reassignment NPD Authorized official
• Paul P Zimmerman, DPM

  • Primary Podiatric Medicine Podiatrist
  • Boone, NC
  • NPI 1588667687
  Medicare reassignment NPD
• John Christopher Moore, DPM

  • Foot & Ankle Surgery Podiatrist
  • Asheville, NC
  • NPI 1790852895
  NPD

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703721600000",
    "number": "1760109862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 MIMOSA DR",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288061719",
            "telephone_number": "828-280-2565",
            "fax_number": "828-252-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 STATE FARM RD STE C",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286074713",
            "telephone_number": "828-265-3668",
            "fax_number": "828-265-4417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hospital Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "Jefferson",
            "state": "NC",
            "postal_code": "286409244",
            "country_code": "US",
            "telephone_number": "828-265-9668",
            "fax_number": "828-252-2272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MSP BOONE CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-20",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A",
        "authorized_official_last_name": "TENLEY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-265-3668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Lynn Moul
• Mountain Care Facilities
• Mountain Family Medicine
• Mountain Laurel Family Practice, PLLC
• Mountaineer Medical Services, PLLC
• Edith N Mubanda, RD.,LDN
• Howard Warren Mueller, M.D., PH.D.
• Carmen Danielle Mullen, PT
• Markus Muller, RPH
• Margaret Mozingo Mullins, NP

• Podiatrist in Boone, NC
• Providers in Boone, NC by specialty
• Podiatrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.