LOUDON COUNTY PEDIATRICS, PC (NPI# 1578881132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578881132 |
| Entity Type | Organization |
| Organization Name | LOUDON COUNTY PEDIATRICS, PC |
| Practice Address |
423 Medical Park Dr Lenoir City TN 37772-5640 |
| Practice Telephone | 8659869233 |
| Practice Fax Number | 8659860148 |
| Mailing Telephone | 8659869233 |
| Mailing Fax Number | 8659860148 |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2010-05-06 |
| Authorized Official Name | DWIGHT DANIEL BIVENS (SECRETARY/TREASURER) |
| Authorized Official Telephone | 8659869233 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0200X |
Clinical Nurse Specialist Specialization: Pediatrics |
145961 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | NPPES | 1265462287 | 01 |
| TN | NPPES | 1841514155 | 01 |
| Street Address |
423 MEDICAL PARK DR |
| City | LENOIR CITY |
| State | TN |
| Zip Code | 37772-5640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922080936 | Parkwest Medical Center | Clinic/Center | 423 Medical Park Dr, Lenoir City, TN 37772-5640 | 2005-11-16 |
| 1649718065 | Joshua Reagan | Counselor | 423 Medical Park Dr, Lenoir City, TN 37772-5640 | 2017-02-06 |
| 1871985796 | Jessica Cagle | Counselor | 423 Medical Park Dr, Lenoir City, TN 37772-5640 | 2015-03-02 |
| 1275972895 | Avni B Patel | Family Medicine | 423 Medical Park Dr, Suite 100, Lenoir City, TN 37772-5640 | 2013-06-17 |
| 1881037067 | Sallie Ray | Counselor | 423 Medical Park Dr, Lenoir City, TN 37772-5640 | 2013-04-08 |
| 1679811434 | Camie D. Manning | Social Worker | 423 Medical Park Dr, Lenoir City, TN 37772-5640 | 2013-01-29 |
| 1700123890 | Michelle Hatter | Counselor | 423 Medical Park Dr, Lenoir City, TN 37772-5640 | 2013-01-09 |
| 1548541147 | Matthew R. Moore | Social Worker | 423 Medical Park Dr, Lenoir City, TN 37772-5640 | 2011-09-09 |
| 1730468182 | Covenant Medical Group, Inc | Specialist | 423 Medical Park Dr, Ste 100, Lenoir City, TN 37772-5640 | 2011-08-16 |
| 1063644789 | John Mason | Counselor | 423 Medical Park Dr, Suite 400, Lenoir City, TN 37772-5640 | 2009-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811458565 | Physician Associate Resources, Plc | Physician Assistant | 1559 Highland Park Drive, Lenoir City, TN 37772 | 2019-03-26 |
| 1447732235 | Back To Nu Low T Solutions, LLC | Nurse Practitioner | 2271 Highway 11 E Unit 1, Lenoir City, TN 37772 | 2018-08-29 |
| 1225519549 | Li Yin Chin Goode | Physical Therapist | 576 Ft Loudoun Med Ctr Dr Ste 100a, Lenoir City, TN 37772 | 2018-08-24 |
| 1982051298 | Louis I Reper II | Podiatrist | 125 Town Creek Rd E Ste 3, Lenoir City, TN 37772 | 2016-05-17 |
| 1407293293 | Summit Medical Group, Pllc | Internal Medicine | 4160 Medical Park Dr., Suite 107, Lenoir City, TN 37772 | 2013-06-03 |
| 1417080896 | Wendy L Taylor | Nurse Practitioner | 125 East Town Creek Rd., Suite 2b, Lenoir City, TN 37772 | 2007-03-14 |
| 1639213796 | Generations Obgyn,p.c. | Specialist | 576 Ft. Loudoun Profesional Bldg, Suite 207, Lenoir City, TN 37772 | 2007-02-20 |
| 1366584104 | Mary Louise Mortimer | Internal Medicine | 2771 Hwy 11 East, Suite 5, Lenoir City, TN 37772 | 2007-02-12 |
| 1366501892 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 802 Hall St, Ste 4, Lenoir City, TN 37772 | 2006-12-08 |
| 1093890733 | Howard Gene Holmes | Internal Medicine | 460 Medical Park Dr., Suite 102, Lenoir City, TN 37772 | 2006-10-25 |
| Find all providers in zip 37772 | ||||
| Taxonomy Code | 364SP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902203284 | Joshua Cole | Clinical Nurse Specialist | 5308 Greenbriar Rd, Chattanooga, TN 37412-3002 | 2014-12-02 |
| 1366756082 | University of Tennessee | Clinical Nurse Specialist | 220 Langland Street, Knoxville, TN 37915 | 2010-08-05 |
| 1356618987 | Ashley Kirkpatrick Williams | Clinical Nurse Specialist | 1817 W Morris Blvd, Morristown, TN 37813-2837 | 2011-11-28 |
| 1952684268 | Alicia M. Alexander | Clinical Nurse Specialist | 220 Langland St, Knoxville, TN 37915-1415 | 2011-09-22 |
| 1609020122 | Amber Bennett Wetherington | Clinical Nurse Specialist | 2100 W Clinch Ave, Ste 120, Knoxville, TN 37916 | 2008-11-11 |
| 1457503021 | Virginia Stafford Hile | Clinical Nurse Specialist | 125 Huxley Rd, Knoxville, TN 37922-3197 | 2008-10-15 |
| 1437305653 | Anila Bhimani | Clinical Nurse Specialist | 1930 Alcoa Hwy, Suite 145, Knoxville, TN 37920-1500 | 2008-08-08 |
| 1396910618 | Dale Gouldie | Clinical Nurse Specialist | 125 Huxley Rd, Knoxville, TN 37922-3197 | 2008-04-28 |
| 1508042276 | Jacqueline Farris | Clinical Nurse Specialist | 4299 Elvis Presley Blvd, Memphis, TN 38116-6435 | 2008-01-12 |
| City | LENOIR CITY |
| Zip Code | 37772 |
Please comment or provide details below to improve the information on LOUDON COUNTY PEDIATRICS, PC.
| 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.