Individual provider Active NPI

Carol J Iddins, MD

  • Occupational Medicine Physician
  • Oak Ridge, TN
National Provider Identifier
1932221827
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
26217 Issued in TN
Practice address
1299 Bethel Valley Rd
Box 117 Reacts
Oak Ridge, TN 37830-8007
Phone
(865) 576-3131
Fax
(865) 576-9522
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 26217 TN Primary

Addresses

Primary practice location

1299 Bethel Valley Rd
Box 117 Reacts
Oak Ridge, TN 37830-8007

Mailing address

PO Box 117
Ms 39 Reacts
Oak Ridge, TN 37831-0117
Phone (865) 576-3131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26217TNMDOccupational Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1932221827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 117",
            "address_2": "MS 39 REACTS",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378310117",
            "telephone_number": "865-576-3131",
            "fax_number": "865-576-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 BETHEL VALLEY RD",
            "address_2": "BOX 117 REACTS",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378308007",
            "telephone_number": "865-576-3131",
            "fax_number": "865-576-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDDINS",
        "first_name": "CAROL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "TN",
            "license": "26217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.