ADVANCED MEDICAL GROUP


Address: 717 Watkins Rd, Maryville, TN 37801-4598
Phone: 8659807802

ADVANCED MEDICAL GROUP (NPI# 1205167509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1205167509
Entity Type Organization
Organization Name ADVANCED MEDICAL GROUP
Other Organization Name FOOTHILLS PAIN MANAGEMENT
Practice Address 717 Watkins Rd
Maryville
TN 37801-4598
Mailing Address 615 Leeper Pkwy
Lenoir City
TN 37772-6151
Practice Telephone 8659807802
Practice Fax Number 8659807804
Mailing Telephone 8659868600
Mailing Fax Number 8659860961
Enumeration Date 2010-01-26
Last Update Date 2010-01-26
Authorized Official Name TERRY BRAGG (PRESIDENT)
Authorized Official Telephone 8659827802
Authorized Official Credential DC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363LA2200X Nurse Practitioner
Specialization: Adult Health
000011720 TN Physician Assistants & Advanced Practice Nursing Providers
N 363LA2200X Nurse Practitioner
Specialization: Adult Health
0000013567 TN Physician Assistants & Advanced Practice Nursing Providers
Y 208D00000X General Practice 0682 TN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TN 1510839 05

Other Provider/Organization Names

Other Name Type Code
Foothills Pain Management Doing Business As Name - Organization

Other Provider IDs and Locations

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1992723639 Advanced Medical Group Rehabilitation Practitioner 155 Union St, Springfield, MA 01105-2010 2006-07-18

Other Data Sources

Entity Type Entity Name Entity Address
Colorado Business Entities Advanced Medical Group Pikes Peak, LLC 2728 Golden Current View, Colorado Springs, CO 80918
New York State Corporations ADVANCED MEDICAL GROUP, P.C. 2044 Ocean Avenue / Suite A-3, Brooklyn, Ny 11230

Office Location

Street Address 717 WATKINS RD
City MARYVILLE
State TN
Zip Code 37801-4598

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1912536582 Andrea Waldrop Pharmacist 103 Foothills Mall Drive, Maryville, TN 37801 2020-04-06
1134664147 Complete Vision Care Pllc Optometrist 2410 Us Hwy 411 S, Maryville, TN 37801 2016-12-29
1144634114 James Muscari Dentist 824 W. Lamar Alexander Pkwy, Maryville, TN 37801 2014-06-17
1245465483 Respiratory Home Care of Bristol, LLC Durable Medical Equipment & Medical Supplies 637 Morganton Square Dr, Maryville, TN 37801 2009-05-18
1063682383 William R Pedersen Optometrist 730 West Lamar Alexander Pkwy, Maryville, TN 37801 2008-03-03
1124218573 Liberty Assisted Living LLC Assisted Living Facility 312 Mcmaster Pl, Liberty Assisted Living LLC, Maryville, TN 37801 2007-07-31
1447467493 Amanda G Clement Nurse Practitioner 1427 William Blount Drive, Maryville, TN 37801 2007-05-17
1396873758 David T Cope Audiologist 821 Ross Drive, Maryville, TN 37801 2007-02-28
1649345406 Adult & Family Dentistry, Inc. Dentist 1740 Big Springs Rd, Maryville, TN 37801 2006-11-21
1225109523 Lincare Inc. Durable Medical Equipment & Medical Supplies 330 Southdowne Dr, Maryville, TN 37801 2006-11-10
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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

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1609069822 Kelli Louise Dubinsky General Practice 30227 Us Highway 136, Maryville, MO 64468-8353 2007-08-21
1366913881 Sunshine Medical Centers PC General Practice 380 High St, Maryville, TN 37804-5846 2018-12-10

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Competitor

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City MARYVILLE
Zip Code 37801

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Dataset Information

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.

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