Thomas Wannenburg (NPI# 1346225380, PAC ID# 6608904420) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CARDIAC ELECTROPHYSIOLOGY.
| Nation Provider ID (NPI) | 1346225380 |
| PAC ID by PECOS | 6608904420 |
| Professional Enrollment ID | I20150624002410 |
| Full Name | Thomas Wannenburg |
| Organization Legal Name | COVENANT MEDICAL GROUP INC |
| Address |
9320 Park W Blvd Knoxville TN 37923-4301 |
| Phone Number | 8653737100 |
| Gender | M |
| Graduation Year | 1982 |
| Primary Specialty | CARDIAC ELECTROPHYSIOLOGY |
| Secondary Specialties | CARDIOVASCULAR DISEASE (CARDIOLOGY) |
| Group Practice PAC ID | 2860305463 |
| Number of Group Practice Members | 215 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440173 | PARKWEST MEDICAL CENTER |
| 440009 | CUMBERLAND MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 9320 Park W Blvd, Knoxville, TN 37923-4301 | 8653737100 | COVENANT MEDICAL GROUP INC |
| 9352 Park W Boulevard, Knoxville, TN 37923-4325 | 8656945700 | PARKWEST MEDICAL CENTER |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | COVENANT MEDICAL GROUP INC |
| Physicians | 229 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jacob E Gingerich | General Surgery | Covenant Medical Group Inc | 703 Mcfarland St, Morristown, TN 37814-3977 |
| Kelly E Bewsey | Urology | Covenant Medical Group Inc | 701 Mcfarland St, Morristown, TN 37814-3977 |
| Tyler Gilbert Gunderson | Orthopedic Surgery | Covenant Medical Group Inc | 118 Brown Ave, Suite 103, Crossville, TN 38555-7740 |
| Daniel I. Cordas | Orthopedic Surgery | Covenant Medical Group Inc | 629 Middlecreek Rd, Sevierville, TN 37862-5014 |
| Brijal P Patel | Internal Medicine | Covenant Medical Group Inc | 103 Bennett Rd, Oliver Springs, TN 37840-5008 |
| Brittany Hill Slatton | Nurse Practitioner | Covenant Medical Group Inc | 100 Lantana Rd, Suite 202, Crossville, TN 38555-1903 |
| April Freeman | Nurse Practitioner | Covenant Medical Group Inc | 110 Industrial Park Lane, Lake City, TN 37769-2300 |
| Troy Wayne Stovall | Family Medicine | Covenant Medical Group Inc | 423 Medical Park Dr, Suite 100, Lenoir City, TN 37772-5641 |
| Joseph C Petit | Cardiovascular Disease (cardiology) | Covenant Medical Group Inc | 576 Ft Loudon Medical Ctr, Suite 200, Lenoir City, TN 37772 |
| Jadeleize Gormley | Nurse Practitioner | Covenant Medical Group Inc | 9320 Park W Blvd, Knoxville, TN 37923-4301 |
| Street Address |
9320 PARK W BLVD |
| City | KNOXVILLE |
| State | TN |
| Zip | 37923-4301 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jadeleize Gormley | Nurse Practitioner | Covenant Medical Group Inc | 9320 Park W Blvd, Knoxville, TN 37923-4301 |
| Mitchell H Weiss | Cardiovascular Disease (cardiology) | Covenant Medical Group Inc | 9320 Park W Blvd, Knoxville, TN 37923-4301 |
| Max W Lawson Jr. | Cardiovascular Disease (cardiology) | Covenant Medical Group Inc | 9320 Park W Blvd, Knoxville, TN 37923-4301 |
| Ogei Yar | Cardiovascular Disease (cardiology) | Covenant Medical Group Inc | 9320 Park W Blvd, Knoxville, TN 37923-4301 |
| Natalie Steele Bradford | Cardiovascular Disease (cardiology) | Covenant Medical Group Inc | 9320 Park W Blvd, Knoxville, TN 37923-4301 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ronald Allen | Psychologist, Clinical | 9217 Park W Blvd, Suite D 1, Knoxville, TN 37923 | |
| Renee J Repka | Psychologist, Clinical | 9217 Park W Blvd, Suite D 1, Knoxville, TN 37923 | |
| Terry L Hallwachs | Physician Assistant | Southeastern Emergency Services P C | 9352 Park W Blvd, Knoxville, TN 37923 |
| Krystal C Killom | Nurse Practitioner | Gregory Brewer, M.d.,pllc | 314 Prosperity Dr, Knoxville, TN 37923 |
| Catherine D Custer | Nurse Practitioner | Minuteclinic Diagnostic of Tennessee PC | 9137 Middlebrook Pike, Knoxville, TN 37923-1425 |
| Sharon L Cathers | Nurse Practitioner | The Little Clinic of Tennessee LLC | 9161 Middlebrook Pike, Knoxville, TN 37923-1438 |
| Lisa Fincher Mccune | Registered Dietitian Or Nutrition Professional | The Little Clinic of Tennessee LLC | 9161 Middlebrook Pike, Knoxville, TN 37923-1438 |
| Sherri Gray | Nurse Practitioner | Summit Medical Group, Pllc | 8635 Middlebrook Pike, Knoxville, TN 37923-1612 |
| Sandra Daniels | Physical Therapy | Kramer Physical Therapy LLC | 8663 Middlebrook Pike, Knoxville, TN 37923-1612 |
| Patricia S. Green | Physical Therapy | Kramer Physical Therapy LLC | 8663 Middlebrook Pike, Knoxville, TN 37923-1612 |
| Find all physicians in zip 37923 | |||
| City | KNOXVILLE |
| Zip Code | 37923 |
| Specialty | CARDIAC ELECTROPHYSIOLOGY |
| City + Specialty | KNOXVILLE + CARDIAC ELECTROPHYSIOLOGY |
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| 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.