SHELLY J MCINTOSH FNP NPI 1003872623

Nurse Practitioner (Family) in Johnson City, TN

About SHELLY MCINTOSH

Shelly Mcintosh is a provider in Johnson City, TN with more than 13 years of experience. The NPI number assigned to this provider is 1003872623. The practitioner's primary taxonomy code is Nurse Practitioner (363LF0000X). The provider is registered as an individual and their NPI record was last updated one year ago. Shelly Mcintosh is registered with Medicare and accepts claims assignment.

NPI1003872623 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name SHELLY J MCINTOSH FNP
Provider Location Address301 MED TECH PKWY SUITE 240 JOHNSON CITY, TN 37604 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing AddressPO BOX 3889 JOHNSON CITY, TN 37602 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderFemale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Medical School NameOTHER
Graduation Year2005
Is Sole Proprietor?No
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date04-22-2006 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date08-29-2016 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

SHELLY J MCINTOSH FNP
301 MED TECH PKWY
SUITE 240
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 794-5520
Fax: (423) 282-0720
Get Directions

Mailing Address

SHELLY J MCINTOSH FNP
PO BOX 3889
JOHNSON CITY, TN
ZIP 37602
Phone: (423) 794-5738
Fax: (423) 283-9480

Primary Taxonomy

Taxonomy Code363LF0000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
SpecializationFamily
License No.APN12000
License StateTN

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyRN127044TNNo

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
3643640MEDICARE PIN (08)TN
3643640MEDICAID (05)TN

Map Location


SHELLY J MCINTOSH FNP address is 301 MED TECH PKWY SUITE 240 JOHNSON CITY, TN 37604

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1063417194 BRIAN H DUNKELBERGER M.D.
Individual
Obstetrics & Gynecology301 MED TECH PKWY STE. 200
JOHNSON CITY, TN 37604
(423) 794-1300
1073847216 ASHLEY PIERCE SEALE PA-C
Individual
Physician Assistant301 MED TECH PKWY STE 240
JOHNSON CITY, TN 37604
(423) 794-5520
1093041865 MIRANDA G WORLEY PA-C
Individual
Physician Assistant (Medical)301 MED TECH PKWY STE 240
JOHNSON CITY, TN 37604
(423) 794-5520
1104821347 MARCIA SENTELL M.D.
Individual
Obstetrics & Gynecology301 MED TECH PKWY STE 200
JOHNSON CITY, TN 37604
(423) 794-1300
1134389497DR. KELLIE TAYLOR SORRELL M.D.
Individual
Family Medicine301 MED TECH PKWY 120
JOHNSON CITY, TN 37604
(423) 794-5570
1235134073 TREVOR J GAGE M.D.
Individual
Pediatrics301 MED TECH PKWY STE. 180
JOHNSON CITY, TN 37604
(423) 794-5540
1366440307DR. SHOKO HANSEN M.D.
Individual
Internal Medicine301 MED TECH PKWY STE. 240
JOHNSON CITY, TN 37604
(423) 794-5520
1366871030MRS. CARRIE ELIZABETH LEWEY PA
Individual
Physician Assistant (Medical)301 MED TECH PKWY STE 240
JOHNSON CITY, TN 37604
(423) 794-5520
1396740957 KEITH R COOK M.D.
Individual
Internal Medicine301 MED TECH PKWY STE 240
JOHNSON CITY, TN 37604
(423) 794-5520
1417181868DR. AZADEH KHEZRI M.D.
Individual
Internal Medicine301 MED TECH PKWY STE 240
JOHNSON CITY, TN 37604
(423) 794-5520
1417952656 DAVID P ROE M.D.
Individual
Obstetrics & Gynecology301 MED TECH PKWY
JOHNSON CITY, TN 37604
(423) 794-5500
1477558690 JILL R TALLEY-HORNE M.D.
Individual
Obstetrics & Gynecology301 MED TECH PKWY STE 200
JOHNSON CITY, TN 37604
(423) 794-1300
1487983003MOUNTAIN STATES HEALTH ALLIANCE
Organization
Clinic/Center (Radiology)301 MED TECH PKWY SUITE 100
JOHNSON CITY, TN 37604
(423) 610-6226
1609871730 CHARLES A FISH M.D.
Individual
Pediatrics301 MED TECH PKWY STE. 180
JOHNSON CITY, TN 37604
(423) 794-5540
1629073846 KEVIN D SWEET M.D.
Individual
Internal Medicine301 MED TECH PKWY STE 240
JOHNSON CITY, TN 37604
(423) 794-5520
1740285881 WILLIAM A BRIDGFORTH M.D.
Individual
Pediatrics301 MED TECH PKWY STE. 180
JOHNSON CITY, TN 37604
(423) 794-5540
1831143106MRS. GINGER WILLIAMS CARTER MD
Individual
Obstetrics & Gynecology301 MED TECH PKWY SUITE 200
JOHNSON CITY, TN 37604
(423) 794-1300
1851392153 LINDSAY MESSINGER M.D.
Individual
Radiology (Diagnostic Radiology)301 MED TECH PKWY STE 100
JOHNSON CITY, TN 37604
(423) 794-5580
1962524017 ELIZABETH ANN SMITH NP
Individual
Nurse Practitioner (Family)301 MED TECH PKWY SUITE 240
JOHNSON CITY, TN 37604
(423) 794-5500
1992700041 BOYCE M BERRY M.D.
Individual
Pediatrics301 MED TECH PKWY SUITE 180
JOHNSON CITY, TN 37604
(423) 794-5540