Ibis Danitzia Nunez-Santiago, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1174 Issued in SC

Practice address

119 Boone Ridge Dr
Ste 201
Johnson City, TN 37615-4998

Phone

(423) 282-1480

Fax

(423) 928-1353

NPI assigned

Apr 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

BH Services Southeast 1 PCGroup PAC ID 7012457054, 96 clinicians

NV Pacs 2 LLCGroup PAC ID 0941550578, 119 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• BH Services Southeast 1 PC

  • Nurse Practitioner
  • Brownsville, TN
  • NPI 1164251526
  Medicare reassignment Care Compare group NPD
• NV Pacs 2 LLC

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1427534809

  TN

  Medicare reassignment Care Compare group NPD
• Ipc Pac Healthcare Services of Tennessee PC

  • Internal Medicine Physician
  • Bristol, TN
  • NPI 1104277656

  Psychologist

  Medicare reassignment NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441
  Medicare reassignment NPD
• CS Pacs 3 Southeast, LLC

  • Hospitalist Physician
  • Bluefield, WV
  • NPI 1154104958

  TN

  Medicare reassignment NPD
• Enduring Care Concepts, PLLC

  • General Practice Physician
  • Hendersonville, NC
  • NPI 1770918294
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1871614420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2034",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287792034",
            "telephone_number": "828-586-8160",
            "fax_number": "828-586-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 BOONE RIDGE DR",
            "address_2": "STE 201",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154998",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNEZ-SANTIAGO",
        "first_name": "IBIS",
        "middle_name": "DANITZIA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "4066",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "SC",
            "license": "1174",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "3389",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nu-Liferx, LLC
• Dawn M Nuckolls, DO
• Manisha Nukavarapu
• Holly Renee Nummerdor, DO
• Jaylah Cheval Nunez-Radden
• Alisa F Nunley, BSS
• Rebecca Lou Nunley, DDS
• Alyssa Nunn, PA
• Nutrition in Sight
• Uchenna C Nwosu, M.D.

• Psychologist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.