East Tennessee State University
NPI 1285264531ActiveOrganization· Family Medicine· Johnson City, TN
Family Medicine in Johnson City, Tennessee, registered in NPPES in January 2020. The authorized official on file is Mouzon Bass, Administrator/Agent.
Overview
| NPI | 1285264531 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 24, 2020 |
| Last updated in NPPES | Dec 17, 2021 |
| Certified by provider | Dec 17, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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