National Provider Identifier Database

SOUTHEASTERN EMERGENCY SERVICES P C
Nurse Practitioner

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.


Contact Information

SOUTHEASTERN EMERGENCY SERVICES P C
1114 W MADISON AVE
ATHENS, TN37371
Phone: 423-745-1411
Fax:
Website:
Specialty Taxonomy Code
* Nurse Practitioner 363L00000X
Medical 363AM0700X
Pediatric Emergency Medicine 207PP0204X
Pediatrics 363LP0200X
Physician Assistant 363A00000X

* Indicates primary specialty

NPI Profile & details for SOUTHEASTERN EMERGENCY SERVICES P C

NPI Number 1669414264
Legal business name
LBN
SOUTHEASTERN EMERGENCY SERVICES P C
Authorized official RANDAL DABBS - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 06/11/2006
Last updated 09/14/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • AL Medicaid: 529929400
  • KY Medicaid: 7100010470
  • KY Medicaid: 78903671
  • MO Medicaid: 507432003
  • MS Medicaid: 02121280
  • MS Medicaid: 05515899
  • MS Medicaid: 06310389
  • NC Medicaid: 2348298
  • SC Medicaid: GP4818

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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