1588921407 NPI number — DR. KAYLEIGH MCDANIEL LITTON D.O.

Table of content: MR. RICHARD R KERST LPCC (NPI 1619108594)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588921407 NPI number — DR. KAYLEIGH MCDANIEL LITTON D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LITTON
Provider First Name:
KAYLEIGH
Provider Middle Name:
MCDANIEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588921407
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/02/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
MSC 8179
Provider Second Line Business Mailing Address:
PO BOX 415000
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37241-8179
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-544-2800
Provider Business Mailing Address Fax Number:
865-544-6812

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1940 ALCOA HWY STE E310
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37920-2267
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-544-2800
Provider Business Practice Location Address Fax Number:
865-544-6812
Provider Enumeration Date:
04/17/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  2574 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: 2571 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0011X , with the licence number: 2571 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: Q016908 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".