NPIMap

Organization Active NPI

Medical Education Assistance Corporation

  • Reproductive Endocrinology Physician
  • Johnson City, TN
National Provider Identifier
1780953729
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
MD35556 Issued in TN
Legal business name
MEDICAL EDUCATION ASSISTANCE CORPORATION
Practice address
1319 Sunset Dr
Suite 103
Johnson City, TN 37604-3799
Phone
(423) 439-7246
Fax
(423) 282-4698
NPI assigned
Dec 20, 2011
Last updated
Mar 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X MD35556 TN
Reproductive Endocrinology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VE0102X MD35556 TN Primary

Addresses

Primary practice location

1319 Sunset Dr
Suite 103
Johnson City, TN 37604-3799

Mailing address

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

Other names 1

  • Quillen Fertility and Women's Services 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

NPI Registry JSON

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1780953729",
    "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": "1319 SUNSET DR",
            "address_2": "SUITE 103",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043799",
            "telephone_number": "423-439-7246",
            "fax_number": "423-282-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL EDUCATION ASSISTANCE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2015-03-30",
        "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"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "MD35556",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "TN",
            "license": "MD35556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quillen Fertility and Women's Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.