MARK S CLEM (NPI# 1417942657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417942657 |
Entity Type | Individual |
Full Name | MARK S CLEM |
Credential | PA-C |
Practice Address |
9125 Cross Park Dr Suite 200 Knoxville TN 37923-4505 |
Mailing Address |
304 Wright St Suite 200 Sweetwater TN 37874-1181 |
Practice Telephone | 8656325900 |
Practice Fax Number | 8655465227 |
Mailing Telephone | 8656325900 |
Mailing Fax Number | 8655465227 |
Enumeration Date | 2005-09-14 |
Last Update Date | 2016-08-04 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363A00000X | Physician Assistant | 110001634 | VA | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA1617 | TN | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
VA | 010184487 | 05 |
Street Address |
9125 CROSS PARK DR SUITE 200 |
City | KNOXVILLE |
State | TN |
Zip Code | 37923-4505 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689126096 | Lauren Wicker | Physician Assistant | 9125 Cross Park Dr, Suite 200, Knoxville, TN 37923-4564 | 2016-11-02 |
1285184580 | Hannah C Royer | Nurse Practitioner | 9125 Cross Park Dr, Ste 200, Knoxville, TN 37923-4564 | 2016-10-11 |
1922556679 | Kathryn Lea Cousins | Nurse Practitioner | 9125 Cross Park Dr, Suite 200, Knoxville, TN 37923-4564 | 2016-09-12 |
1801341854 | Ashley Wade | Nurse Practitioner | 9125 Cross Park Dr, Suite 200, Knoxville, TN 37923-4564 | 2016-08-19 |
1548521859 | Associated Home Care Inc | Home Health | 9125 Cross Park Dr, 100, Knoxville, TN 37923 | 2012-06-04 |
1861624868 | Zachary Swanson | Physician Assistant | 9125 Cross Park Dr, Suite 200, Knoxville, TN 37923-4564 | 2009-08-10 |
1134354822 | Henry F Todd IIi | Surgery | 9125 Cross Park Dr, Suite 200, Knoxville, TN 37923-4564 | 2009-05-25 |
1457535379 | Carlo O. Martinez Torres | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 9125 Cross Park Dr, Suite 200, Knoxville, TN 37923-4564 | 2007-12-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114541240 | Chloe Morgan | Registered Nurse | Parkwest Blvd, Knoxville, TN 37923 | 2020-06-04 |
1215551346 | Kaylee Huskey | Registered Nurse | Park West Blvd, Knoxville, TN 37923 | 2020-06-04 |
1942849914 | American Brace & Limb Enterprise, LLC | Prosthetic/Orthotic Supplier | 9333 Parkwest Blvd., 103, Knoxville, TN 37923 | 2019-12-23 |
1619510690 | Stacia Working | Speech-Language Pathologist | 310 Corporate Dr, Ste 101, Knoxville, TN 37923 | 2019-10-23 |
1497242903 | Mary Ensminger Loomis | Speech-Language Pathologist | 118 N Peters Rd Ste 174, Knoxville, TN 37923 | 2018-04-19 |
1831699602 | Shaun Elizabeth Hoffman | Counselor | 311 Directors Dr, Knoxville, TN 37923 | 2018-02-17 |
1962948737 | East Tennessee Binocular Vision Center Pllc | Optometrist | 9051 Executive Park Dr., Ste. 400, Knoxvville, TN 37923 | 2017-01-17 |
1467815761 | Hearing Conservation Associates Inc | Audiologist | 9301 Parkwest Blvd B-3, Knoxville, TN 37923 | 2016-04-04 |
1710354725 | Independent Physical Therapy, LLC | Occupational Therapist | 8905 Town and Country Cir Ste 9, Knoxville, TN 37923 | 2015-08-25 |
1568863553 | Kathryn Faye Ledbetter | Registered Nurse | 9352 Park W Blvd, Knoxville, TN 37923 | 2014-09-09 |
Find all providers in zip 37923 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932450301 | Martha Pamela Guel | Physician Assistant | 2681 Honey Hill Rd, Knoxville, TN 37924-1159 | 2012-09-26 |
1952498420 | Charles Phillip Brandt | Physician Assistant | 101 E Blount Ave Ste 800, Knoxville, TN 37920-1669 | 2006-10-06 |
1184694713 | Melissa S Napier | Physician Assistant | 4713 Papermill Dr Ste 100, Knoxville, TN 37909-1924 | 2006-01-25 |
1407329923 | Sara Kaniper | Physician Assistant | 10810 Parkside Dr Ste 208, Knoxville, TN 37934-1981 | 2019-01-08 |
1689126096 | Lauren Wicker | Physician Assistant | 9125 Cross Park Dr, Suite 200, Knoxville, TN 37923-4564 | 2016-11-02 |
1952793135 | Mary Kathryn Massaro | Physician Assistant | 1934 Alcoa Hwy, Ste 362, Knoxville, TN 37920-1524 | 2015-02-25 |
1518239474 | Brian S. Powell | Physician Assistant | 1932 Alcoa Hwy Ste 360, Knoxville, TN 37920-1509 | 2012-02-07 |
1902128812 | Stephanie Kelley Lezatte | Physician Assistant | 1932 Alcoa Hwy, Building C Suite 255, Knoxville, TN 37920-1527 | 2010-02-18 |
1366764276 | Nicholas Mark Baloga | Physician Assistant | 1932 Alcoa Hwy, Ste 360, Knoxville, TN 37920-1509 | 2010-02-18 |
1871640722 | Steven L Zurlinden | Physician Assistant | 10810 Parkside Dr Ste 208, Knoxville, TN 37934-1981 | 2007-01-04 |
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.