EAST TENNESSEE ADDICTION SPECIALISTS (NPI# 1770080632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770080632 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE ADDICTION SPECIALISTS |
| Practice Address |
2022 Chilhowee Medical Park Maryville TN 37804-5285 |
| Practice Telephone | 4360865268 |
| Mailing Telephone | 8652684360 |
| Mailing Fax Number | 8653296507 |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2019-02-25 |
| Authorized Official Name | PAUL CAUDILL (CONSULTANT) |
| Authorized Official Telephone | 6155219097 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q045176 | 05 |
| Street Address |
2022 CHILHOWEE MEDICAL PARK |
| City | MARYVILLE |
| State | TN |
| Zip Code | 37804-5285 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427612027 | Kati Kerr Carley | Nurse Practitioner | 2022 Chilhowee Medical Park, Maryville, TN 37804-5285 | 2019-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659835825 | Matthew David Mallory | Physical Therapist | Morning View Village 2320 E. Lamar Alexander Parway, Maryville, TN 37804 | 2019-01-22 |
| 1063937290 | Rachel Ryan Mcmillan | Counselor | 362 High Street, Maryville, TN 37804 | 2017-08-09 |
| 1316461460 | Steven Casey Boring | Nurse Practitioner | 907 E. Lamar Alexander Pkwy., Maryville, TN 37804 | 2017-07-31 |
| 1851738751 | Robert Kane Mccall | Pathology | 250 E. Broadway, Maryville, TN 37804 | 2013-05-31 |
| 1619242849 | Jennifer Mcclements | Physical Therapy Assistant | 4004 Samuel Circle, Maryville, TN 37804 | 2012-03-21 |
| 1316223886 | Sabrina Nicole Powers | Social Worker | 1704 East Broadway, Maryville, TN 37804 | 2011-10-28 |
| 1407138381 | Russmann, Inc. | Ambulance | 4163 Benny Delozier Drive, Maryville, TN 37804 | 2011-09-15 |
| 1184932485 | Complete Family Care of Maryville, Pllc | Internal Medicine | 2004 E. Broadway, Maryville, TN 37804 | 2010-09-21 |
| 1093975096 | Kristi Clark Correll | Speech-Language Pathologist | 2030 East Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-12 |
| 1134388267 | Barbara Frantz Poulsen | Speech-Language Pathologist | 2030 E Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-04 |
| Find all providers in zip 37804 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811508765 | Pw-hospital Bridge Services, LLC | Family Medicine | 801 Hill St Ste A, Springfield, TN 37172-2951 | 2020-08-13 |
| 1285268243 | Alpha Medical Center, LLC | Family Medicine | 1421 W Baddour Pkwy Ste A, Lebanon, TN 37087-2652 | 2020-02-28 |
| 1770133597 | Renewal Healthcare | Family Medicine | 7035 Middlebrook Pike, Knoxville, TN 37909 | 2019-09-13 |
| 1518425941 | Hamm, Blackstock & Stern, Pllc | Family Medicine | 2135 Dalkeith Dr, Germantown, TN 38139-3407 | 2019-03-05 |
| 1336636158 | Foundation Medical, Inc. | Family Medicine | 1730 Old Gray Station Rd, Johnson City, TN 37615-3869 | 2018-04-17 |
| 1912418435 | Sunrise Medical Associates Inc. | Family Medicine | 9 Worth Cir Ste 100, Johnson City, TN 37601-4358 | 2017-10-24 |
| 1851810774 | Physician Hope and Wellness Center | Family Medicine | 1915c Church St, Nashville, TN 37203-2203 | 2017-09-12 |
| 1619409489 | Watauga Recovery Center Greeneville | Family Medicine | 819 W Church Street, Greeneville, TN 37745 | 2017-03-31 |
| 1568913663 | Watauga Recovery Center Newport PC | Family Medicine | 330 Heritage Blvd, Newport, TN 37821-4257 | 2016-10-24 |
| 1831640937 | Watauga Recovery Center Morristown P.C. | Family Medicine | 1369 W Andrew Johnson Hwy, Johnson City, TN 37604 | 2016-10-24 |
| Find all providers with the same taxonomy | ||||
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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.