St Marys OBGYN LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

ST MARYS OBGYN LLC

Practice address

120 Hospital Dr
Suite 250
Jefferson City, TN 37760-5279

Phone

(865) 471-2644

Fax

(865) 471-2649

NPI assigned

Apr 24, 2006

Last updated

Aug 7, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

ST. MARY'S HEALTH SYSTEM, INCAs reported in NPPES

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

Authorized official

Name

Mrs. Debra K London

Title

Chief Executive Officer

Phone

(865) 545-7558

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Knoxville Hma Homecare DME & Hospice LLC

  dba Tennova DME

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1245212729

  Member Of

  NPD member

Locations

Practitioners 2

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.

• Kimberly Sue Bolton, PHD, WHCNP

  • Religious Nonmedical Nursing Personnel
  • Knoxville, TN
  • NPI 1750594925
  NPD (past)
• Duy-Thu P. D. Martin, M.D.

  • Obstetrics & Gynecology Physician
  • Knoxville, TN
  • NPI 1912973066
  NPD (past)

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249603200000",
    "number": "1912963422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 EAST OAK HILL AVENUE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379174556",
            "telephone_number": "865-545-8000",
            "fax_number": "865-545-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HOSPITAL DR",
            "address_2": "SUITE 250",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377605279",
            "telephone_number": "865-471-2644",
            "fax_number": "865-471-2649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARYS OBGYN LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. MARY'S HEALTH SYSTEM, INC",
        "enumeration_date": "2006-04-24",
        "last_updated": "2009-08-07",
        "status": "A",
        "authorized_official_last_name": "LONDON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "865-545-7558",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Jean Smith, MSN, RN, FNP-BC,CDE
• Melissa D Smith, D.PH.
• Tabetha Ann Sparks, APN
• Rebecca Speight, ATC, LAT
• Dennis U Spjut, PHD
• St. Mary's Cardiology, LLC (Jefferson Heart Consultants)
• Martha Startup, PT
• Carol Steele, PH.D.
• Stephen Bencho
• Rachael Stephenson, PHARMD

• Obstetrics & Gynecology Physician in Jefferson City, TN
• Providers in Jefferson City, TN by specialty
• Obstetrics & Gynecology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; 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.