MINDFUL RECOVERY ADDICTION SPECIALIST, LLC (NPI# 1497252357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1497252357 |
Entity Type | Organization |
Organization Name | MINDFUL RECOVERY ADDICTION SPECIALIST, LLC |
Practice Address |
20463 Alberta St Oneida TN 37841 |
Mailing Address |
20463 Alberta St Oneida TN 37841-3509 |
Practice Telephone | 4232863292 |
Mailing Telephone | 4232863292 |
Enumeration Date | 2018-04-09 |
Last Update Date | 2018-07-03 |
Authorized Official Name | PAUL CAUDILL (ENROLLMENT CONSULTANT) |
Authorized Official Telephone | 6155219097 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
Street Address |
20463 ALBERTA ST |
City | ONEIDA |
State | TN |
Zip Code | 37841 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861647976 | Nate Aaron Brennan | Podiatrist | 20463 Alberta St, Oneida, TN 37841-3509 | 2008-11-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811495161 | Kristin Alexis Henry | Physical Therapist | 530 Industrial Ln, Oneida, TN 37841 | 2018-01-31 |
1730504754 | Southern Psychiatric Services | Psychiatry & Neurology | 216 North Cross Street, Oneida, TN 37841 | 2014-02-27 |
1700142619 | Stephen Daniel Cross | Pharmacist | 20029 Alberta St., Oneida, TN 37841 | 2012-04-04 |
1730342700 | Ava Lynn Adcock | Speech-Language Pathologist | 127 Cross Street, Oneida, TN 37841 | 2008-07-09 |
1922289560 | Scott County Surgical Associates P.a. | Surgery | 615 N. Main Street, Oneida, TN 37841 | 2007-11-26 |
1205035185 | James Wyatt Denzler | Pharmacist | 19856 Alberta St, Oneida, TN 37841 | 2007-07-12 |
1073735569 | Dennis K Baird | Dentist | 204 South Bank Street, Oneida, TN 37841 | 2007-05-03 |
1629103635 | J. Gregory Roberts Md Rvt | Specialist | 223 Andrew Dr, Oneida, TN 37841 | 2007-02-22 |
1790840767 | Synergistics, Inc. | Occupational Therapy Assistant | 125 Cross Street, Oneida, TN 37841 | 2006-12-27 |
1033282405 | Scott County Medical Clinic Inc | Clinic/Center | 19268 Alberta Ave, Oneida, TN 37841 | 2006-11-15 |
Find all providers in zip 37841 |
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 |
1770080632 | East Tennessee Addiction Specialists | Family Medicine | 2022 Chilhowee Medical Park, Maryville, TN 37804-5285 | 2018-04-09 |
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 |
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.