PRODIGAL PRIMARY CARE PC (NPI# 1306196530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306196530 |
| Entity Type | Organization |
| Organization Name | PRODIGAL PRIMARY CARE PC |
| Practice Address |
721 Highway 321 N Bld 3 Lenoir City TN 37771-5003 |
| Mailing Address |
2911 Essary Dr Knoxville TN 37918-2468 |
| Practice Telephone | 8652883754 |
| Practice Fax Number | 8653946719 |
| Mailing Telephone | 8652883867 |
| Mailing Fax Number | 8653946719 |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2013-11-01 |
| Authorized Official Name | MR. DAVID E BRICKHOUSE (OWNER) |
| Authorized Official Telephone | 8652883754 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740534049 | Prodigal Primary Care PC | Durable Medical Equipment & Medical Supplies | 901 Merchant Dr, Knoxville, TN 37912-3862 | 2012-11-08 |
| 1861704371 | Prodigal Primary Care PC | Physician Assistant | 2911 Essary Road, Knoxville, TN 37918-2468 | 2010-07-13 |
| 1881033959 | Prodigal Primary Care PC | Durable Medical Equipment & Medical Supplies | 598 John Deere Dr, Maynardville, TN 37807-3212 | 2013-06-21 |
| 1063762649 | Prodigal Primary Care PC | Durable Medical Equipment & Medical Supplies | 2911 Essary Road, Knoxville, TN 37918-2468 | 2012-09-11 |
| Street Address |
721 HIGHWAY 321 N BLD 3 |
| City | LENOIR CITY |
| State | TN |
| Zip Code | 37771-5003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467447425 | David N Montgomery | Optometrist | 721 Highway 321 N, Ste 3, Lenoir City, TN 37771-5003 | 2005-09-15 |
| 1679026116 | Tarah R Slusher | Pharmacist | 721 Highway 321 N, Lenoir City, TN 37771-5003 | 2016-08-02 |
| 1730550567 | Timothy Wilburn | Technician, Other | 721 Highway 321 N, Lenoir City, TN 37771-5003 | 2015-10-20 |
| 1558732743 | Paul Martin | Pharmacist | 721 Highway 321 N, Lenoir City, TN 37771-5003 | 2015-10-13 |
| 1831357532 | Prescription Specialties LLC. | Pharmacy | 721 Highway 321 N, Lenoir City, TN 37771-5003 | 2008-05-29 |
| 1982760229 | Eye Care Centers Pllc | Ophthalmology | 721 Highway 321 N, Ste 3, Lenoir City, TN 37771-5003 | 2006-12-29 |
| 1801836465 | Richard C. Free | Nurse Practitioner | 721 Highway 321 N, Suite C, Lenoir City, TN 37771-5003 | 2006-06-08 |
| 1275599078 | Jodi` P Nowell | Pharmacist | 721 Highway 321 N, Lenoir City, TN 37771-5003 | 2006-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801380621 | Geetika Chirumamilla | Dentist | 375 Kelsey Lane, Suite 1, Lenoir City, TN 37771 | 2018-06-15 |
| 1669918256 | Patrick Anthony Albanese | Pharmacist | 875 Hwy 321 N, Unit 600, Lenoir City, TN 37771 | 2017-01-06 |
| 1598014482 | Comprehensive Healthcare Systems of Lenoir City, PC | Contractor | 780 Highway 321 North Ste 10, Lenoir City, TN 37771 | 2012-09-06 |
| 1750619797 | James Olin Morris | Nurse Practitioner | 840 Hwy 321 N., Living Well Health Cooperative Clinic, Lenoir City, TN 37771 | 2009-12-03 |
| 1427284363 | Charles Preston Mccary IIi | Dentist | 603 Hwy 321 N., Lenoir City, TN 37771 | 2009-06-05 |
| 1619129004 | K Va T Food Stores Inc | Durable Medical Equipment & Medical Supplies | 300 Market Drive, Lenoir City, TN 37771 | 2008-10-16 |
| 1396898052 | David Wayne Holt | Chiropractor | 1005 E Broadway, Lenoir City, TN 37771 | 2007-01-18 |
| 1558428151 | Peter E Mueller | Optometrist | 911 Hwy 321 N, Lenoir City, TN 37771 | 2007-01-02 |
| 1871661371 | Darrick Shane Blankenship | Occupational Therapist | 785 Us Hwy 321 N, Ste 20, Lenoir City, TN 37771 | 2006-12-01 |
| 1851460224 | Cheryl S. Cason | Pharmacy Technician | 501 Adesa Blvd., Suite A 150, Lenoir City, TN 37771 | 2006-11-07 |
| Find all providers in zip 37771 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619129004 | K Va T Food Stores Inc | Durable Medical Equipment & Medical Supplies | 300 Market Drive, Lenoir City, TN 37771 | 2008-10-16 |
| 1366501892 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 802 Hall St, Ste 4, Lenoir City, TN 37772 | 2006-12-08 |
| 1851306872 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 350 Highway 321 N, Lenoir City, TN 37771-2059 | 2006-07-29 |
| 1598782773 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 911 Highway 321 N, Lenoir City, TN 37771-6425 | 2006-07-16 |
| 1467410753 | The Nowell Corporation | Durable Medical Equipment & Medical Supplies | 721-a Highway 321 N, Lenoir City, TN 37771-5003 | 2006-05-03 |
| 1114479557 | Anesthesia Services Associates | Durable Medical Equipment & Medical Supplies | 460 Medical Park Dr Ste 104, Lenoir City, TN 37772-5782 | 2016-11-02 |
| 1497041842 | Cameron Company Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 501 Adessa Pkwy, Suite B210, Lenoir City, TN 37771-6725 | 2011-06-23 |
| 1801970066 | Orthotennessee, PC | Durable Medical Equipment & Medical Supplies | 460 Medical Park Dr, Suite 104, Lenoir City, TN 37772-5640 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851999346 | Izzy Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 1706 Antioch Pike # A, Antioch, TN 37013-2717 | 2020-10-15 |
| 1144827437 | Gb 3445, LLC | Durable Medical Equipment & Medical Supplies | 10820 Kingston Pike Ste 6, Knoxville, TN 37934-3065 | 2020-10-08 |
| 1386241859 | Covenant Medical Group, Inc | Durable Medical Equipment & Medical Supplies | 2001 Laurel Ave Ste 503, Knoxville, TN 37916-1823 | 2020-10-07 |
| 1346851730 | Esight Inc. | Durable Medical Equipment & Medical Supplies | 330 Mallory Station Rd Ste F19, Franklin, TN 37067-2861 | 2020-08-11 |
| 1457961401 | Publix Tennessee, LLC | Durable Medical Equipment & Medical Supplies | 750 Winfield Dunn Parkway, Suite 100, Sevierville, TN 37876 | 2020-08-05 |
| 1578173944 | Publix Tennessee, LLC | Durable Medical Equipment & Medical Supplies | 1111 Gallatin Ave, Nashville, TN 37206-3201 | 2020-07-31 |
| 1588282917 | Rock House Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 25 N Spring St, Sparta, TN 38583 | 2020-07-13 |
| 1568086049 | Limestone Medical LLC | Durable Medical Equipment & Medical Supplies | 1650 Murfreesboro Rd Ste 155, Franklin, TN 37067-5080 | 2020-06-01 |
| 1619590445 | Wayfarer, Inc. | Durable Medical Equipment & Medical Supplies | 1416 Antioch Pike Ste 101, Antioch, TN 37013-2766 | 2020-05-27 |
| 1467075838 | Yolanda S Draine | Durable Medical Equipment & Medical Supplies | 420 Monroe Ave # 1413, Memphis, TN 38103-3252 | 2020-05-20 |
| Find all providers with the same taxonomy | ||||
| City | LENOIR CITY |
| Zip Code | 37771 |
Please comment or provide details below to improve the information on PRODIGAL PRIMARY CARE 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.