MRS. JENNIFER CLARK RISEDEN (NPI# 1104107507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104107507 |
| Entity Type | Individual |
| Full Name | MRS. JENNIFER CLARK RISEDEN |
| Credential | FNP-BC |
| Practice Address |
220 Fort Sanders West Blvd Ste 200 Knoxville TN 37922-3471 |
| Mailing Address |
3620 Raven Grove Way Apt 338 Knoxville TN 37918-7077 |
| Practice Telephone | 8652884232 |
| Practice Fax Number | 8652884231 |
| Mailing Telephone | (865) 712-9191 |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 16065 | TN | Allopathic & Osteopathic Physicians |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
16065 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 460643559 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2911 Essary Dr, Knoxville, TN 379182468 | 8657129191 |
| Street Address |
220 FORT SANDERS WEST BLVD STE 200 |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37922-3471 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346565009 | Mary Ann Hammonds | Nurse Practitioner | 220 Fort Sanders West Blvd Ste 200, Knoxville, TN 37922-3471 | 2010-04-06 |
| 1780159699 | Naveen Mohyuddin | Physician Assistant | 220 Fort Sanders West Blvd Ste 200, Knoxville, TN 37922-3471 | 2018-10-06 |
| 1497189955 | Shastina Parahoo | Physician Assistant | 220 Fort Sanders West Blvd Ste 200, Knoxville, TN 37922-3471 | 2013-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184132185 | Kimberly Zitko | Pharmacist | 400 Goody's Lane, Knoxville, TN 37922 | 2018-01-12 |
| 1366959314 | Matthew Smith | Physician Assistant | 1424 Randall Park Dr, Knoxville, TN 37922 | 2017-12-29 |
| 1174052823 | 24/7 Healthcare, Inc. | Nursing Care | 110 Center Park Drive, Suite 101, Knoxville, TN 37922 | 2017-06-07 |
| 1023543477 | Open Arms Care Corp | Intermediate Care Facility, Mentally Retarded | 12625 S Northshore Dr, Knoxville, TN 37922 | 2017-04-24 |
| 1275905440 | Milligan Surgical Associates, Pllc | Surgery | 1919 Pinnacle Pointe Way, Knoxville, TN 37922 | 2015-10-27 |
| 1275904096 | Medical Necessities & Services LLC | Durable Medical Equipment & Medical Supplies | 9327 S Northshore Dr, Knoxville, TN 37922 | 2015-10-20 |
| 1841668126 | Chad Szala | Behavioral Analyst | 10721 Chapman Hwy #22, Knoxville, TN 37922 | 2015-09-03 |
| 1275916470 | Nikki Nicole Peoples | Acupuncturist | 10406 Jackson Oaks Way Ste A, Knoxville, TN 37922 | 2015-07-07 |
| 1538577747 | Susan Carter | Optometrist | 2053 Thunderhead Rd, Knoxville, TN 37922 | 2014-07-31 |
| 1366868135 | Heartland Infusion | Clinic/Center | 9943 Kingston Pike, Knoxville, TN 37922 | 2014-03-17 |
| Find all providers in zip 37922 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285932 | Caitlyn Lawson | Nurse Practitioner | 7637 Saddlebrooke Dr, Knoxville, TN 37938-4044 | 2020-11-04 |
| 1598371098 | Angela Ruth Porter | Nurse Practitioner | 333 Huxley Rd, Knoxville, TN 37922-3115 | 2020-09-20 |
| 1326653270 | Khalid Khan | Nurse Practitioner | 9036 Highbridge Dr, Knoxville, TN 37922-1439 | 2020-09-08 |
| 1972117042 | Seth Ingebrigtson | Nurse Practitioner | 4707 Seminole Rd, Knoxville, TN 37918-1548 | 2020-09-04 |
| 1013521285 | Ashley Renee Bonnell | Nurse Practitioner | 2667 Sweeping Rain Ln, Knoxville, TN 37931-3170 | 2020-09-03 |
| 1407460207 | Mofoluwasho Adenekan | Nurse Practitioner | 6100 Stratford Park Blvd, Knoxville, TN 37912-2109 | 2020-08-31 |
| 1790395416 | Jessica Moore | Nurse Practitioner | 232 N Watt Rd, Knoxville, TN 37934-1103 | 2020-08-06 |
| 1598375255 | Abbey Rae Powell | Nurse Practitioner | 10119 Tan Rara Dr, Knoxville, TN 37922-4142 | 2020-08-06 |
| 1194335018 | Jennifer Blair Massaro | Nurse Practitioner | 1424 Whitower Dr, Knoxville, TN 37919-8841 | 2020-08-05 |
| 1194333054 | Sara Ann Dajani | Nurse Practitioner | 7600 Redwood Burl Ln, Knoxville, TN 37931-4183 | 2020-07-16 |
| Find all providers in KNOXVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.