1801867114 NPI number — DR. ANDREW S RHINEHART MD, FACP, CDE

Table of content: DR. ANDREW S RHINEHART MD, FACP, CDE (NPI 1801867114)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801867114 NPI number — DR. ANDREW S RHINEHART MD, FACP, CDE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RHINEHART
Provider First Name:
ANDREW
Provider Middle Name:
S
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, FACP, CDE
Provider Gender Code:
M

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:
1801867114
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3700
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JOHNSON CITY
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37602-3700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-952-2122
Provider Business Mailing Address Fax Number:
423-952-2145

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16000 JOHNSTON MEMORIAL DR
Provider Second Line Business Practice Location Address:
SUITE 313
Provider Business Practice Location Address City Name:
ABINGDON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24211-7659
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-258-3780
Provider Business Practice Location Address Fax Number:
276-258-3776
Provider Enumeration Date:
01/27/2006

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:  0101052144 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3079377 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: P01034666 . This is a "RR MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1801867114 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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