Deaver T Shattuck (NPI# 1013985407, PAC ID# 4587569157) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1013985407 |
| PAC ID by PECOS | 4587569157 |
| Professional Enrollment ID | I20031205000421 |
| Full Name | Deaver T Shattuck |
| Organization Legal Name | ENSEMBLE MEDICAL PLLC |
| Address |
417 Holly St Knoxville TN 37917-7815 |
| Phone Number | 8657704003 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE |
| Graduation Year | 1992 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | EMERGENCY MEDICINE |
| Group Practice PAC ID | 1254603145 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440011 | BLOUNT MEMORIAL HOSPITAL |
| 440125 | FORT SANDERS REGIONAL MEDICAL CENTER |
| 440081 | LECONTE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1758 Hillwood Dr, Knoxville, TN 37920-2600 | 8653307425 | HOUSE CALL PRIMARY CARE, PLLC |
| 417 Holly St, Knoxville, TN 37917-7815 | 8657704003 | ENSEMBLE MEDICAL PLLC |
| 907 E Lamar Alexander Pkwy, Maryville, TN 37804-5015 | 8659837211 | BLOUNT MEMORIAL PHYSICIAN GROUP INC |
| Organization Legal Name | ENSEMBLE MEDICAL PLLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Liz T Donald | Psychologist, Clinical | Ensemble Medical Pllc | 417 Holly St, Knoxville, TN 37917-7815 |
| Jamie Gibson Bradshaw | Nurse Practitioner | Ensemble Medical Pllc | 417 Holly St, Knoxville, TN 37917-7815 |
| Street Address |
417 HOLLY ST |
| City | KNOXVILLE |
| State | TN |
| Zip | 37917-7815 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Liz T Donald | Psychologist, Clinical | Ensemble Medical Pllc | 417 Holly St, Knoxville, TN 37917-7815 |
| Jamie Gibson Bradshaw | Nurse Practitioner | Ensemble Medical Pllc | 417 Holly St, Knoxville, TN 37917-7815 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Upinder Dhand | Neurology | Knoxville Hma Physician Management, LLC | 930 Emerald Ave, Suite 511, Knoxville, TN 37917 |
| William A Walker | General Surgery | Knoxville Hma Physician Management, LLC | 930 Emerald Ave, Suite 511, Knoxville, TN 37917 |
| Bonnie E Norman | Nurse Practitioner | 4435 Valley View Dr, Suite 104, Knoxville, TN 37917-1300 | |
| Karen R Black | Nurse Practitioner | University Health System,inc | 4410 Valley View Dr, Knoxville, TN 37917-1304 |
| William S Broome Iii | Family Medicine | University Health System,inc | 4410 Valley View Dr, Knoxville, TN 37917-1304 |
| Robert D. Shutt | Family Medicine | University Health System,inc | 4410 Valley View Dr, Knoxville, TN 37917-1304 |
| Sharon E Glass | Physical Medicine and Rehabilitation | Knoxville Hma Physician Management, LLC | 4711 Centerline Dr, Suite 100, Knoxville, TN 37917-1405 |
| Melissa D Cohen | Clinical Social Worker | 4420 Whittle Springs Rd B, Knoxville, TN 37917-1513 | |
| Christopher D Bennett | Chiropractic | 3018 S Mall Rd, Knoxville, TN 37917-2113 | |
| Judith P Roy | Chiropractic | 4800 Millertown Pike, Knoxville, TN 37917-2138 | |
| Find all physicians in zip 37917 | |||
| City | KNOXVILLE |
| Zip Code | 37917 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | KNOXVILLE + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Deaver T Shattuck.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.