Individual provider Active NPI

Susan P Abernathy, D.O.

  • Otolaryngology Physician
  • Greeneville, TN
National Provider Identifier
1780632141
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
1381 Issued in TN
Practice address
1410 Tusculum Blvd
Suite 2500
Greeneville, TN 37745-5821
Phone
(423) 638-1291
Fax
(423) 638-9398
NPI assigned
May 5, 2006
Last updated
Sep 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 1381 TN Primary

Addresses

Primary practice location

1410 Tusculum Blvd
Suite 2500
Greeneville, TN 37745-5821

Mailing address

1410 Tusculum Blvd
Suite 2500
Greeneville, TN 37745-5821
Phone (423) 638-1291

Other identifiers 1

IdentifierTypeStateIssuer
3373004MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101108000783 TN Practitioner - Otolaryngology 8527021369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greeneville Ear, Nose and Throat Specialists, MpllcGroup PAC ID 4385607126, 4 clinicians

Practice addresses (Care Compare)

1410 Tusculum Blvd
Greeneville, TN 37745-5821
Phone (423) 638-1291

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Greeneville Ear, Nose & Throat Specialists, Mpllc CurrentSince Jan 1, 2001 Accepting new patients

Locations

1410 Tusculum Blvd
Ste 2500
Greeneville, TN 37745
Phone (423) 638-1291

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1780632141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 TUSCULUM BLVD",
            "address_2": "SUITE 2500",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377455821",
            "telephone_number": "423-638-1291",
            "fax_number": "423-638-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 TUSCULUM BLVD",
            "address_2": "SUITE 2500",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377455821",
            "telephone_number": "423-638-1291",
            "fax_number": "423-638-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABERNATHY",
        "first_name": "SUSAN",
        "middle_name": "P",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TN",
            "license": "1381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3373004",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeneville, TN

Sources for this page

Verify at the official NPI Registry.