PRODIGAL PRIMARY CARE PC (NPI# 1861704371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861704371 |
| Entity Type | Organization |
| Organization Name | PRODIGAL PRIMARY CARE PC |
| Practice Address |
2911 Essary Road Knoxville TN 37918-2468 |
| Practice Telephone | 8652882754 |
| Practice Fax Number | 8652432250 |
| Mailing Telephone | 8652883754 |
| Mailing Fax Number | 8652432250 |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2013-08-21 |
| Authorized Official Name | DAVID E BRICKHOUSE (OWNER) |
| Authorized Official Telephone | 8652883754 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1506 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1521979 | 05 |
| 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 |
| 1881033959 | Prodigal Primary Care PC | Durable Medical Equipment & Medical Supplies | 598 John Deere Dr, Maynardville, TN 37807-3212 | 2013-06-21 |
| 1306196530 | Prodigal Primary Care PC | Durable Medical Equipment & Medical Supplies | 721 Highway 321 N, Bld 3, Lenoir City, TN 37771-5003 | 2012-09-14 |
| 1063762649 | Prodigal Primary Care PC | Durable Medical Equipment & Medical Supplies | 2911 Essary Road, Knoxville, TN 37918-2468 | 2012-09-11 |
| Street Address |
2911 ESSARY ROAD |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37918-2468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063762649 | Prodigal Primary Care PC | Durable Medical Equipment & Medical Supplies | 2911 Essary Road, Knoxville, TN 37918-2468 | 2012-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639636145 | Samantha Fuhrmann | Physical Therapy Assistant | Beverly Park Place Health and Rehab, 5321 Beverly Park Circle, Knoxville, TN 37918 | 2019-02-21 |
| 1043701741 | Lauren Lea Wilson | Student in an Organized Health Care Education/Training Program | 4230 Homewood Rd, Knoxville, TN 37918 | 2018-05-29 |
| 1164790317 | Jennifer Young Brooks | Pharmacist | 5006 North Broadway, Knoxville, TN 37918 | 2011-12-02 |
| 1215213194 | Lu Miller | Pharmacist | 5006 N Broadway, Knoxville, TN 37918 | 2011-10-24 |
| 1326353475 | Lauren Joy Stone | Optometrist | 4829 N Broadway St Ste 103, Knoxville, TN 37918 | 2010-08-13 |
| 1699004531 | Larry Kyle Sowder | Dentist | 2944 Tazewell Pk, Ste #2, Knoxville, TN 37918 | 2009-12-23 |
| 1922233881 | Andrea' Lamar Farrior | Dentist | 2937 Essary Rd., Dr. Michael Edenfield, Knoxville, TN 37918 | 2009-05-21 |
| 1053558510 | Love-hope Academy | Counselor | 3826 Tiberius Rd Ste 315, Knoxville, TN 37918 | 2009-01-20 |
| 1497910293 | Diana Lynn Mccoy | Psychologist | 5019 Jacksboro Pike, Knoxville, TN 37918 | 2008-07-22 |
| 1740498088 | Kathleen M Riley | Pharmacist | K-mart Pharmacy #7460, 6906 Manardville Pike Ne, Knoxville, TN 37918 | 2007-05-18 |
| Find all providers in zip 37918 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538772744 | Kaitlyn Blair Barger | Physician Assistant | 2100 Clinch Ave Ste 120, Knoxville, TN 37916-2288 | 2020-08-26 |
| 1225653967 | Molly Ann Waggoner | Physician Assistant | 9050 Executive Park Dr Ste 100b, Knoxville, TN 37923-4616 | 2020-06-09 |
| 1164942355 | Debra Lynn Howard | Physician Assistant | 9314 Park West Blvd Ste 100, Knoxville, TN 37923-4338 | 2017-06-20 |
| 1255702635 | Community Healthcare | Physician Assistant | 507 N Cedar Bluff Rd, Knoxville, TN 37923-2805 | 2015-10-12 |
| 1053653220 | Amber L. Burns | Physician Assistant | 501 20th St Ste 303, Knoxville, TN 37916-1899 | 2013-03-26 |
| 1497044671 | Katie Bean | Physician Assistant | 8025 Kingston Pike Ste 1, Knoxville, TN 37919-5582 | 2011-03-28 |
| 1336476159 | George F. Hillegas IIi | Physician Assistant | 3904 Lonas, Pa Program South College, Knoxville, TN 37909 | 2009-11-16 |
| 1225263353 | Douglas E Lillifield | Physician Assistant | 431 Park Village Dr Ste 103, Knoxville, TN 37923 | 2009-05-19 |
| 1720263213 | Leslie Anne Heller | Physician Assistant | 814 E Woodland Ave, Knoxville, TN 37917-5648 | 2008-01-03 |
| 1275720492 | Phillip Darrell Kirkland | Physician Assistant | 8115 Beaver Ridge Rd, Knoxville, TN 37931-3314 | 2007-10-02 |
| 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.