Fabrice Medastin, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

0000258450 Issued in TN

Practice address

601 Cumberland St
Chattanooga, TN 37404-1922

Phone

(423) 266-6751

NPI assigned

Dec 14, 2021

Last updated

Dec 14, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Helen Ross McNabb Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Knoxville, TN
  • NPI 1659330686
  NPD
• American Medical Response of Tennessee, Inc.

  dba American Medical Response

  • Ambulance
  • Horn Lake, MS
  • NPI 1295108306
  NPD (past)

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1972262343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TECH CENTER DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379122747",
            "telephone_number": "865-637-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CUMBERLAND ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041922",
            "telephone_number": "423-266-6751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDASTIN",
        "first_name": "FABRICE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-14",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "0000258450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William E Meadows III, MD
• Augustus E Mealor, MD
• Med Lifts LLC
• Med-Ray, Inc.
• Med-Ray, Inc.
• Medi Pedi Wellness Empire
• Medical Arts Pharmacy, Inc.
• Medical Attire
• Medical Necessities & Services LLC
• Medicor Healthcare Inc

• Registered Nurse in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.