DR. EDWARD JOHN PRIMKA III (NPI# 1134105919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134105919 |
| Entity Type | Individual |
| Full Name | DR. EDWARD JOHN PRIMKA III |
| Credential | M.D. |
| Practice Address |
1450 Dowell Springs Blvd Ste 210 Knoxville TN 37909-2448 |
| Practice Telephone | 8655242547 |
| Practice Fax Number | 8652055601 |
| Mailing Telephone | 8655242547 |
| Mailing Fax Number | 8652055601 |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2020-08-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | MD0000035486 | TN | Allopathic & Osteopathic Physicians |
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
MD0000035486 | TN | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
MD0000035486 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | CIGNA | 3788990004 | 01 |
| TN | PHP TNCARE | 100035981 | 01 |
| TN | AETNA | 5533476 | 01 |
| SD | TRICARE FARRAGUT | 621247710 | 01 |
| SD | RAILROAD MEDICARE | 70015833 | 01 |
| TN | UNITED HEALTHCARE | 340133 | 01 |
| TN | TRICARE ST.MARY'S | 621247710001 | 01 |
| TN | 386126 | 05 | |
| TN | BLUE CROSS BLUE SHIELD | 4015496 | 01 |
| Street Address |
1450 DOWELL SPRINGS BLVD STE 210 |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37909-2448 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043666886 | Amanda Nicole Maples | Physician Assistant | 1450 Dowell Springs Blvd Ste 210, Knoxville, TN 37909-2448 | 2016-05-11 |
| 1124303334 | Marcus Rene Ortiz Jr. | Dermatology | 1450 Dowell Springs Blvd Ste 210, Knoxville, TN 37909-2448 | 2011-10-19 |
| 1659318764 | Kevin Carter Blanton | Dermatology | 1450 Dowell Springs Blvd Ste 210, Knoxville, TN 37909-2448 | 2006-05-31 |
| 1447201264 | Sharon L Mcnutt | Physician Assistant | 1450 Dowell Springs Blvd Ste 210, Knoxville, TN 37909-2448 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326687534 | Rosalie Ting Mcglashen | Behavioral Analyst | 1508 Coleman Rd., Suites 105 and 110, Knoxville, TN 37909 | 2020-01-06 |
| 1770133597 | Renewal Healthcare | Family Medicine | 7035 Middlebrook Pike, Knoxville, TN 37909 | 2019-09-13 |
| 1417461211 | Lean Knox, LLC | Family Medicine | 1415 Old Weisgarber Rd. Ste 350, Knoxville, TN 37909 | 2017-12-01 |
| 1750757514 | Victor Brown | Counselor | 1451 Dowell Springs Blvd., Knoxville, TN 37909 | 2015-08-17 |
| 1083012488 | Melissa Wells Woodby | Marriage & Family Therapist | 6305 Lonas Dr, Knoxville, TN 37909 | 2014-12-17 |
| 1417375700 | David Francis Fair | Chiropractor | 1720 Tonalea Rd, Knoxville, TN 37909 | 2014-04-03 |
| 1295157519 | Danny Adkins, D.d.s. | Dentist | 1301 Old Weisgarber Road, Knoxville, TN 37909 | 2014-01-07 |
| 1376971085 | Quality Health Clinic LLC | Clinic/Center | 7348 Middlebrook Pike Suite D, Knoxville, TN 37909 | 2013-10-16 |
| 1952737942 | Martirea Fostine Jenkins Pratt | Nurse Practitioner | 930 Adell Ree Park Lane, Knoxville, TN 37909 | 2013-09-23 |
| 1104259324 | Dana Michelle Sweitzer | Nurse Practitioner | 1320 Old Weisgarber Road, Knoxville, TN 37909 | 2013-08-12 |
| Find all providers in zip 37909 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245679661 | Maya Aravind Raiman | Dermatology | 939 E Emerald Ave Ste 705, Knoxville, TN 37917-4573 | 2013-06-19 |
| 1619235355 | Robert Denison Griffith | Dermatology | 6311 Kingston Pike Ste 22e, Knoxville, TN 37919 | 2012-05-01 |
| 1619204476 | Carley O'shea Fowler | Dermatology | 220 Fort Sanders West Blvd Ste 100, Knoxville, TN 37922-3373 | 2009-11-14 |
| 1861439648 | Kevin Blazer | Dermatology | 1928 Alcoa Hwy Ste 209, Knoxville, TN 37920-1504 | 2006-06-01 |
| 1306891494 | Matthew Brent Doppelt | Dermatology | 1924 Pinnacle Pt, 300, Knoxville, TN 37922-6648 | 2006-05-24 |
| 1073589925 | Elizabeth Brittian Anderson | Dermatology | 6516 Kingston Pike, Knoxville, TN 37919-4825 | 2006-02-28 |
| 1942286729 | George C Keough | Dermatology | 123 Fox Rd, Knoxville, TN 37922-3369 | 2005-12-22 |
| 1023534732 | Brittany Noel Ware | Dermatology | 10215 Kingston Pike Ste 200, Knoxville, TN 37922-3492 | 2017-08-15 |
| 1851747695 | Joshua Randall Bakke | Dermatology | 6516 Kingston Pike, Knoxville, TN 37919-4825 | 2016-05-11 |
| 1184094898 | Claude C. Frazier, IIi, Do | Dermatology | 501 19th St, Ste 309, Knoxville, TN 37916-1854 | 2015-10-07 |
| 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.