NPIMap

Organization Active NPI

East Tennessee Dermatology Group, PC

  • Dermatology Physician
  • Alcoa, TN
National Provider Identifier
1891050407
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD0000035046 Issued in TN
Legal business name
EAST TENNESSEE DERMATOLOGY GROUP, PC
Practice address
133 Associates Blvd
Alcoa, TN 37701-1944
Phone
(865) 233-7351
Fax
(865) 233-7352
NPI assigned
Jul 10, 2012
Last updated
Aug 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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

Authorized official

Name
Robert Paul Unkefer, M.D.NPI 1861579989
Title
President
Phone
(865) 233-7351

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD0000035046 TN Primary
MOHS-Micrographic Surgery Physician 207ND0101X MD0000035046 TN
Procedural Dermatology Physician 207NS0135X MD0000035046 TN

Addresses

Primary practice location

133 Associates Blvd
Alcoa, TN 37701-1944

Mailing address

133 Associates Blvd
Alcoa, TN 37701-1944
Phone (865) 233-7351

National Provider Directory

National Provider Directory

Locations

133 Associates Blvd
Alcoa, TN 37701
Phone (865) 233-7351

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344556800000",
    "number": "1891050407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 ASSOCIATES BLVD",
            "city": "ALCOA",
            "state": "TN",
            "postal_code": "377011944",
            "telephone_number": "865-233-7351",
            "fax_number": "865-233-7352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 ASSOCIATES BLVD",
            "city": "ALCOA",
            "state": "TN",
            "postal_code": "377011944",
            "telephone_number": "865-233-7351",
            "fax_number": "865-233-7352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TENNESSEE DERMATOLOGY GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-10",
        "last_updated": "2012-08-10",
        "status": "A",
        "authorized_official_last_name": "UNKEFER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-233-7351",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "MD0000035046",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TN",
            "license": "MD0000035046",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "TN",
            "license": "MD0000035046",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alcoa, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; 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.