NPIMap

Organization Active NPI

Blair Primary Care, LLC

  • Primary Care Clinic/Center
  • Etowah, TN
National Provider Identifier
1811348303
Registry record updated Jun 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
18159 Issued in TN
Legal business name
BLAIR PRIMARY CARE, LLC
Practice address
315 Grady Rd
Etowah, TN 37331-1903
Phone
(423) 263-5400
Fax
(423) 263-0674
NPI assigned
Jun 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2016

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

Authorized official

Name
Joshua C Blair, FNP-BC
Title
Nurse Practitioner
Phone
(423) 263-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 18159 TN Primary

Addresses

Primary practice location

315 Grady Rd
Etowah, TN 37331-1903

Mailing address

PO Box 842
Etowah, TN 37331-0842
Phone (423) 263-5400

National Provider Directory

National Provider Directory

Locations

315 Grady Rd
Etowah, TN 37331
Phone (423) 263-5400

NPI Registry JSON

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

{
    "created_epoch": "1466812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466812800000",
    "number": "1811348303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842",
            "city": "ETOWAH",
            "state": "TN",
            "postal_code": "373310842",
            "telephone_number": "423-263-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 GRADY RD",
            "city": "ETOWAH",
            "state": "TN",
            "postal_code": "373311903",
            "telephone_number": "423-263-5400",
            "fax_number": "423-263-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAIR PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-25",
        "last_updated": "2016-06-25",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "423-263-5400",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TN",
            "license": "18159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Etowah, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.

Verify at the official NPI Registry.