| Beacon Sleep Services Pllc | |
|
110 Corporate Dr Ste 110 Johnson City TN 37604-2008 | |
| (423) 328-0363 | |
| Not Available |
| Full Name | Beacon Sleep Services Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 110 Corporate Dr Ste 110, Johnson City, Tennessee |
| Authorized Official Name and Position | Christopher M. Nolte (OWNER) |
| Authorized Official Contact | 9042269767 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Sleep Services Pllc Dept #88318 Knoxville TN 37995-0001 Ph: (865) 670-6199 | Beacon Sleep Services Pllc 110 Corporate Dr Ste 110 Johnson City TN 37604-2008 Ph: (423) 328-0363 |
| NPI Number | 1164806352 |
|---|---|
| Provider Enumeration Date | 07/17/2015 |
| Last Update Date | 04/11/2024 |
| Certification Date | 04/11/2024 |
| Medicare PECOS PAC ID | 0648571844 |
|---|---|
| Medicare Enrollment ID | O20151211002087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164806352 | NPI | - | NPPES |
| Q014466 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084S0012X | Psychiatry & Neurology - Sleep Medicine | (Tennessee) | Primary |
| Provider Name | Elizabeth L Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972776854 PECOS PAC ID: 3971682378 Enrollment ID: I20080510000040 |
| Provider Name | Christopher M Nolte |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1790768091 PECOS PAC ID: 2668545369 Enrollment ID: I20080714000322 |
| Provider Name | Grant A Partin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992247530 PECOS PAC ID: 5991088353 Enrollment ID: I20170208002072 |
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