Active NPI
DRS Montenegro & de Wit
- Specialist
- Johnson City, TN
National Provider Identifier
1972602894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 013647
- Legal business name
- DRS MONTENEGRO & DE WIT
- Practice address
- 310 N State of Franklin Rd
Suite 201
Johnson City, TN 37604-6008 - Phone
- (423) 928-3051
- Fax
- (423) 928-8840
- NPI assigned
- Sep 21, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Albertine De Wit, M.D.
- Title
- Owner
- Phone
- (423) 928-3051
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 013647 | TN | Primary |
Addresses
Primary practice location
310 N State of Franklin Rd
Suite 201
Johnson City, TN 37604-6008
Mailing address
310 N State of Franklin Rd
Suite 201
Johnson City, TN 37604-6008
Phone (423) 928-3051
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15491 | Other | TN | BCBS |
| 3382675 | Medicaid | TN | |
| 129760 | Other | TN | TRIGON BCBS |
National Provider Directory
National Provider DirectoryLocations
310 N State of Franklin Rd
Ste 201
Johnson City, TN 37604
Phone (423) 928-3051
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Rheumatology Physician
- Johnson City, TN
- NPI 1528018520
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1972602894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 N STATE OF FRANKLIN RD",
"address_2": "SUITE 201",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376046008",
"telephone_number": "423-928-3051",
"fax_number": "423-928-8840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 N STATE OF FRANKLIN RD",
"address_2": "SUITE 201",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376046008",
"telephone_number": "423-928-3051",
"fax_number": "423-928-8840"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DRS MONTENEGRO & DE WIT",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-21",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "DE WIT",
"authorized_official_first_name": "ALBERTINE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "423-928-3051",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist",
"state": "TN",
"license": "013647",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "15491",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3382675",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIGON BCBS",
"identifier": "129760",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Johnson 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.