ENDOSCOPY CENTER OF NORTHEAST TENNESSEE, PC – NPI #1164488219
Clinic/Center

ENDOSCOPY CENTER OF NORTHEAST TENNESSEE, PC is an AHC clinic located in JOHNSON CITY, TN. NPPES has assigned the NPI number 1164488219 to ENDOSCOPY CENTER OF NORTHEAST TENNESSEE, PC on April 25, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ENDOSCOPY CENTER OF NORTHEAST TENNESSEE, PC below.

NPI Profile for
ENDOSCOPY CENTER OF NORTHEAST TENNESSEE, PC

NPI Number
1164488219
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ENDOSCOPY CENTER OF NORTHEAST TENNESSEE, PC
Primary location
310 N STATE OF FRANKLIN RD
SUITE 202
JOHNSON CITY, TN 37604-6008
Phone: (423) 929-7111 Fax: (423) 929-9448
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
PENNY RUTLEDGE
FACILITY ADMINISTRATOR
Phone: (423) 929-7111
Updated
Identifiers

Identifiers for ENDOSCOPY CENTER OF NORTHEAST TENNESSEE, PC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDTN3287479
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)		 TN 0000000056

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.