NPIMap

Organization Active NPI

Jefferson Family Physicians P C

  • Family Medicine Physician
  • Jefferson City, TN
National Provider Identifier
1972524239
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JEFFERSON FAMILY PHYSICIANS P C
Practice address
1810 Bishop Ave
Suite a
Jefferson City, TN 37760-1997
Phone
(865) 475-6161
Fax
(865) 475-9857
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dewayne P Darby, M.D.NPI 1740203207
Title
An Owner
Phone
(865) 475-6161

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1810 Bishop Ave
Suite a
Jefferson City, TN 37760-1997

Mailing address

1810 Bishop Ave
Suite a
Jefferson City, TN 37760-1997
Phone (865) 475-6161

Other identifiers 2

IdentifierTypeStateIssuer
3712179MedicaidTN
3712170MedicaidTN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972524239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 BISHOP AVE",
            "address_2": "SUITE A",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377601997",
            "telephone_number": "865-475-6161",
            "fax_number": "865-475-9857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 BISHOP AVE",
            "address_2": "SUITE A",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377601997",
            "telephone_number": "865-475-6161",
            "fax_number": "865-475-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON FAMILY PHYSICIANS P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DARBY",
        "authorized_official_first_name": "DEWAYNE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "AN OWNER",
        "authorized_official_telephone_number": "865-475-6161",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3712179",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3712170",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.