Active NPI
Raymond Bales
- Adult Companion
- Knoxville, TN
National Provider Identifier
1790220903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- License
- I000000019088
- Practice address
- 304 Wardley Rd
Knoxville, TN 37934-1829 - Phone
- (865) 269-4483
- Fax
- (865) 288-7974
- NPI assigned
- Dec 23, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | I000000019088 | TN | Primary |
Addresses
Primary practice location
304 Wardley Rd
Knoxville, TN 37934-1829
Mailing address
304 Wardley Rd
Knoxville, TN 37934-1829
Phone (865) 269-4483
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| I000000019088 | Other | TN | NON-MEDICAL IN HOME CARE AGENCY |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I000000019088 | TN | MD | Adult Companion |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482451200000",
"number": "1790220903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 WARDLEY RD",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379341829",
"telephone_number": "865-269-4483",
"fax_number": "865-288-7974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 WARDLEY RD",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379341829",
"telephone_number": "865-269-4483",
"fax_number": "865-288-7974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALES",
"first_name": "RAYMOND",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-12-23",
"last_updated": "2016-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "TN",
"license": "I000000019088",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NON-MEDICAL IN HOME CARE AGENCY",
"identifier": "I000000019088",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.