Tri-Cities Pediatric Endocrinology, PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

37128 Issued in TN

Legal business name

TRI-CITIES PEDIATRIC ENDOCRINOLOGY, PLLC

Practice address

140 Old Gray Station Rd
Suite 200
Gray, TN 37615-3612

Phone

(423) 483-0828

Fax

(423) 546-4103

NPI assigned

Nov 19, 2013

Last updated

Feb 5, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mary Gwyn Roper, M.D., F.A.A.P.

Title

Owner

Phone

(423) 483-0828

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1384819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423094400000",
    "number": "1851721369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3343",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376023343",
            "telephone_number": "423-483-0828",
            "fax_number": "423-546-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 OLD GRAY STATION RD",
            "address_2": "SUITE 200",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376153612",
            "telephone_number": "423-483-0828",
            "fax_number": "423-546-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CITIES PEDIATRIC ENDOCRINOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-19",
        "last_updated": "2015-02-05",
        "status": "A",
        "authorized_official_last_name": "ROPER",
        "authorized_official_first_name": "MARY GWYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-483-0828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., F.A.A.P."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TN",
            "license": "37128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April N Steele, NP
• H Patrick Stern, MD
• Alan Murise Stevens, D.D.S.
• Denise M Sturgill
• Ernest Lowell Thomason Jr., RN
• Melissa Renee Trinidad, PA-C
• Richard Anthony Turner, D.M.D.
• Amber Lynette Vance, FNP-BC
• Arissa Brooke Vaughn, PHARMD
• Walgreen Co (Walgreens #11113)

• Medical Specialty Clinic/Center in Gray, TN
• Providers in Gray, TN by specialty
• Medical Specialty Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.