Jay Alan Dedeker, MSS

Primary specialty

Respiratory/Developmental/Rehabilitative Specialist/TechnologistTaxonomy code 225500000X

Practice address

6711 Mountain View Rd Ste 115
Ooltewah, TN 37363-6667

Phone

(423) 238-1127

Fax

(423) 238-1277

NPI assigned

Apr 23, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1831416395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6711 MOUNTAIN VIEW RD STE 115",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636667",
            "telephone_number": "423-238-1127",
            "fax_number": "423-238-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6711 MOUNTAIN VIEW RD STE 115",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636667",
            "telephone_number": "423-238-1127",
            "fax_number": "423-238-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDEKER",
        "first_name": "JAY",
        "middle_name": "ALAN",
        "credential": "MSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• David H. Otis, D.D.S.
• Susan Camille Davidson, APRN, NP-C
• Abri-Ronel Delgado
• Jeremiah Charles Dell, O.D.
• Julie Dempsey, MS/CCC-SLP
• Jordan McLean Dennett, PA-C
• John Patrick Depalma, PT

• Respiratory/Developmental/Rehabilitative Specialist/Technologist in Ooltewah, TN
• Providers in Ooltewah, TN by specialty
• Respiratory/Developmental/Rehabilitative Specialist/Technologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.