SOUTHEAST SPINE & PAIN ASSOCIATES LLC (NPI# 1649523689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649523689 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST SPINE & PAIN ASSOCIATES LLC |
| Practice Address |
1718 Saint Mary St Knoxville TN 37917-4517 |
| Mailing Address |
Po Box 27629 Knoxville TN 37927-7629 |
| Practice Telephone | 8656339469 |
| Practice Fax Number | 8656339474 |
| Mailing Telephone | 8656339469 |
| Mailing Fax Number | 8656339474 |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2015-03-12 |
| Authorized Official Name | CHRISTIE LORD (CREDENTIALING/BILLING MANAGER) |
| Authorized Official Telephone | 8656339469 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1531106 | 05 |
| Street Address |
1718 SAINT MARY ST |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37917-4517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346274420 | East Tennessee Neonatal Associates, P.C. | Pediatrics | 1718 Saint Mary St, Knoxville, TN 37917-4517 | 2006-07-11 |
| 1538588439 | Holli Marie Womack | Nurse Practitioner | 1718 Saint Mary St, Knoxville, TN 37917-4517 | 2014-04-08 |
| 1104118835 | Joseph Dichiara | Anesthesiology | 1718 Saint Mary St, Knoxville, TN 37917-4517 | 2011-05-13 |
| 1972771988 | Siridatar K Khalsa-zemel | Dietitian, Registered | 1718 Saint Mary St, Knoxville, TN 37917-4517 | 2008-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033601786 | Angela Marie Barnett | Licensed Practical Nurse | 201 W Springdale Ave # 203, Knoxville, TN 37917 | 2018-05-30 |
| 1790283588 | Kevin Johnson | Case Manager/Care Coordinator | 201 W. Springfield Ave, Knoxville, TN 37917 | 2018-01-26 |
| 1871011437 | Sara Portwood | Registered Nurse | 140 Dameron Ave., Knoxville, TN 37917 | 2017-09-05 |
| 1962926295 | Dara Steele | Counselor | 201 West Springdale, Knoxville, TN 37917 | 2017-07-28 |
| 1043740657 | Stacy Banks | Counselor | 201 West Springdale Ave., Knoxville, TN 37917 | 2017-06-15 |
| 1861921215 | Amy J Mccowan | Registered Nurse | 201 W. Springdale Ave., Knoxville, TN 37917 | 2017-06-08 |
| 1942756523 | Skyler Daegan Winkler | Counselor | 201 West Springvale Avenue, Knoxville, TN 37917 | 2016-09-01 |
| 1821454216 | Beth Cannon | Case Manager/Care Coordinator | 201 West Sprindale Ave, Knoxville, TN 37917 | 2016-01-14 |
| 1760874986 | Sierra Brooke Finley | Case Manager/Care Coordinator | 201 W. Springdale Ave, Knoxville, TENNESSEE 37917 | 2015-02-25 |
| 1568860377 | Megumi Takayama Maynard | Family Medicine | 900 E. Oak Hill Avenue, Knoxville, TN 37917 | 2014-12-10 |
| Find all providers in zip 37917 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376971085 | Quality Health Clinic LLC | Clinic/Center | 7348 Middlebrook Pike Suite D, Knoxville, TN 37909 | 2013-10-16 |
| 1558887125 | Pain Medicine of The South, Pllc | Clinic/Center | 110 N Campbell Station Rd, Knoxville, TN 37934 | 2017-08-16 |
| 1558783464 | West Knox Health Inc | Clinic/Center | 431 Park Village Rd, Suite 103, Knoxville, TN 37923-3849 | 2014-01-11 |
| 1508107533 | James E Fox Md Pllc | Clinic/Center | 300 Prosperity Rd Ste 103, Knoxville, TN 37923-4717 | 2013-03-15 |
| 1083983035 | Greater Knoxville Center | Clinic/Center | 417 Holly St, Knoxville, TN 37917-7815 | 2011-12-20 |
| 1003120882 | Tennessee Pain Professionals | Clinic/Center | 2507 Mineral Springs Ave, Suite A, Knoxville, TN 37917-1549 | 2010-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033733167 | Ortho Sport & Spine Physicians Nashville | Clinic/Center | 900 Harpeth Valley Pl, Nashville, TN 37221-1141 | 2020-06-04 |
| 1033694724 | Pain Institute of Nashville, Plc | Clinic/Center | 491 Sage Rd N # 100, White House, TN 37188-9360 | 2018-09-27 |
| 1073049102 | Pain Institute of Nashville, Plc | Clinic/Center | 1849 Madison St Ste F, Clarksville, TN 37043-4903 | 2017-05-10 |
| 1225444748 | Hope Health, LLC | Clinic/Center | 86 Thompson Ln, Nashville, TN 37211-2548 | 2014-07-03 |
| 1487081758 | Tn Premier Care LLC | Clinic/Center | 3609 Outdoor Sportsman Pl Ste 7, Kodak, TN 37764 | 2013-10-02 |
| 1740554393 | Serenity Health Consultants, Inc. | Clinic/Center | 111 Gill St, Alcoa, TN 37701-2672 | 2012-02-29 |
| 1922304500 | Vonore Pain Management | Clinic/Center | 1255 Highway 411, Suite 6, Vonore, TN 37885-2457 | 2011-01-31 |
| 1942381207 | Banyan Healthcare & Wellness Center, LLC | Clinic/Center | 1030 Mcarthur St, Manchester, TN 37355-2453 | 2006-10-17 |
| 1912922428 | Carl S Blankenship | Clinic/Center | 1219 Mcgavock St, Nashville, TN 37203-3129 | 2006-07-13 |
| 1245263292 | Chattanooga Pain Management Center LLC | Clinic/Center | 1016 Executive Dr, Hixson, TN 37343-3995 | 2006-07-09 |
| 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.