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Contact Information

EAST TENNESSEE STATE UNIVERSITY
2151 CENTURY LN
JOHNSON CITY, TN37604-4469
 Phone: 423-926-2500
 Fax: 423-926-5999
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Advanced Practice Midwife

367A00000X 42 Certified Nurse Midwife
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Dentist

122300000X
 

Pediatrics

363LP0200X 50 Nurse Practitioner
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
 

Women's Health

363LW0102X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for EAST TENNESSEE STATE UNIVERSITY

NPI Number 1124593132
LBN Legal business name EAST TENNESSEE STATE UNIVERSITY
Authorized official BETTY KING - (CHIEF FINANCIAL OFFICER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 10/05/2018
Last updated 10/15/2018 - About 8 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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