| Ipc Pac Healthcare Services Of Tennessee Pc | |
|
1 Medical Park Blvd Bristol TN 37620-7430 | |
| (423) 844-1121 | |
| Not Available |
| Full Name | Ipc Pac Healthcare Services Of Tennessee Pc |
|---|---|
| Speciality | Hospitalist |
| Location | 1 Medical Park Blvd, Bristol, Tennessee |
| Authorized Official Name and Position | Randal Dabbs (OWNER/PRESIDENT) |
| Authorized Official Contact | 8656931000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ipc Pac Healthcare Services Of Tennessee Pc 265 Brookview Centre Way Ste 400 Knoxville TN 37919-4052 Ph: (865) 693-1000 | Ipc Pac Healthcare Services Of Tennessee Pc 1 Medical Park Blvd Bristol TN 37620-7430 Ph: (423) 844-1121 |
| NPI Number | 1104277656 |
|---|---|
| Provider Enumeration Date | 06/27/2016 |
| Last Update Date | 10/31/2023 |
| Certification Date | 10/31/2023 |
| Medicare PECOS PAC ID | 0840587572 |
|---|---|
| Medicare Enrollment ID | O20160928000541 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104277656 | NPI | - | NPPES |
| Provider Name | Wayne E Tasker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275526436 PECOS PAC ID: 9234039033 Enrollment ID: I20040109000250 |
| Provider Name | Joyce A Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043217532 PECOS PAC ID: 6901794270 Enrollment ID: I20040308001316 |
| Provider Name | Joseph Anthony Destefano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508841032 PECOS PAC ID: 4688669526 Enrollment ID: I20040419001314 |
| Provider Name | Nancy L Witherspoon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760481451 PECOS PAC ID: 4981694213 Enrollment ID: I20040517001381 |
| Provider Name | Todd W Markwalter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700894276 PECOS PAC ID: 0941283832 Enrollment ID: I20040610001775 |
| Provider Name | Lori Middleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780631945 PECOS PAC ID: 5395728174 Enrollment ID: I20040611000663 |
| Provider Name | Daniel R Duzan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518900091 PECOS PAC ID: 7315911351 Enrollment ID: I20040824001392 |
| Provider Name | Connie J Daniel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750488201 PECOS PAC ID: 0143295659 Enrollment ID: I20040828000211 |
| Provider Name | Eustacia L Pratt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114977972 PECOS PAC ID: 1052371804 Enrollment ID: I20041015000240 |
| Provider Name | Eric K Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285674523 PECOS PAC ID: 8224098983 Enrollment ID: I20041016000199 |
| Provider Name | Steve Dennis Daugherty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558300723 PECOS PAC ID: 6709853450 Enrollment ID: I20041111000099 |
| Provider Name | Vivian Clark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205889508 PECOS PAC ID: 1456301548 Enrollment ID: I20050126000813 |
| Provider Name | Susan Nettleton O Brien |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528001112 PECOS PAC ID: 2769435189 Enrollment ID: I20050225000364 |
| Provider Name | Kimberly S Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306867031 PECOS PAC ID: 0143260943 Enrollment ID: I20050511000631 |
| Provider Name | David A Hancock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194753459 PECOS PAC ID: 1456397405 Enrollment ID: I20050630000236 |
| Provider Name | Rual C Swanson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174529432 PECOS PAC ID: 6204820947 Enrollment ID: I20050801000551 |
| Provider Name | Bipinchandra M Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881655066 PECOS PAC ID: 3971527441 Enrollment ID: I20060126000521 |
| Provider Name | Jonathan S Bremer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336181239 PECOS PAC ID: 4688689243 Enrollment ID: I20060217000626 |
| Provider Name | John W Thurman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790705341 PECOS PAC ID: 3072520246 Enrollment ID: I20060313000510 |
| Provider Name | Fay Lynn Bembry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811098908 PECOS PAC ID: 6305854308 Enrollment ID: I20060403000488 |
| Provider Name | Patricia Estes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629058045 PECOS PAC ID: 3274546262 Enrollment ID: I20060714000212 |
| Provider Name | Deepika A Tumkur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366508681 PECOS PAC ID: 1658474747 Enrollment ID: I20070309000360 |
| Provider Name | Allen L Solomon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922083971 PECOS PAC ID: 8820192826 Enrollment ID: I20070402000060 |
| Provider Name | Joshua Dean Murphy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821203357 PECOS PAC ID: 2860583549 Enrollment ID: I20070809000570 |
| Provider Name | David E Biddle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023218211 PECOS PAC ID: 6103910732 Enrollment ID: I20070913000375 |
| Provider Name | Jennifer C Wisdom-schepers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447264361 PECOS PAC ID: 5991890014 Enrollment ID: I20071004000669 |
| Provider Name | David B Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144490467 PECOS PAC ID: 8628155348 Enrollment ID: I20080404000722 |
| Provider Name | Meenu Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407057409 PECOS PAC ID: 3678595345 Enrollment ID: I20080505000460 |
| Provider Name | Lakieva T Trotter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174791784 PECOS PAC ID: 1557432663 Enrollment ID: I20080617000785 |
| Provider Name | Dewayne S Steffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548252638 PECOS PAC ID: 5991872228 Enrollment ID: I20080929000047 |
| Provider Name | Cynthia L Roberson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629209713 PECOS PAC ID: 5193870582 Enrollment ID: I20090909000207 |
| Provider Name | Stephen C Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891876819 PECOS PAC ID: 5395882674 Enrollment ID: I20091019000276 |
| Provider Name | Michael T Cox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356305197 PECOS PAC ID: 7416098629 Enrollment ID: I20100111000382 |
| Provider Name | Donald W Larkin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609104462 PECOS PAC ID: 0749323202 Enrollment ID: I20100205000211 |
| Provider Name | Radwan R Khuri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578530036 PECOS PAC ID: 8729989926 Enrollment ID: I20100421000461 |
| Provider Name | Jessica Lynn Ball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083938237 PECOS PAC ID: 4587856653 Enrollment ID: I20101007000536 |
| Provider Name | Franchesca Shoun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770817116 PECOS PAC ID: 3476748716 Enrollment ID: I20101111000937 |
| Provider Name | Larry Wayne Barnes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932295342 PECOS PAC ID: 4486731106 Enrollment ID: I20101227000558 |
| Provider Name | Kirsten B Bunce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093750564 PECOS PAC ID: 3678761897 Enrollment ID: I20110103000474 |
| Provider Name | Tonya R Durant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467768499 PECOS PAC ID: 6103006721 Enrollment ID: I20110214000586 |
| Provider Name | Laura Renee Parsons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770888950 PECOS PAC ID: 1759562150 Enrollment ID: I20110217000730 |
| Provider Name | Alyn K Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548579840 PECOS PAC ID: 5395929038 Enrollment ID: I20110405000370 |
| Provider Name | Christine C Hasselle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457330763 PECOS PAC ID: 0840475117 Enrollment ID: I20110502000118 |
| Provider Name | Judith Johns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689965873 PECOS PAC ID: 7012193519 Enrollment ID: I20110518000279 |
| Provider Name | Dawn M Glass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306136742 PECOS PAC ID: 2769669399 Enrollment ID: I20110608000683 |
| Provider Name | Makram Jurdi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124281894 PECOS PAC ID: 0648444521 Enrollment ID: I20111111000446 |
| Provider Name | Candace S Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811271406 PECOS PAC ID: 5395910103 Enrollment ID: I20111206000612 |
| Provider Name | Michael T Gardner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609149210 PECOS PAC ID: 4789844937 Enrollment ID: I20120326000173 |
| Provider Name | Sara E Andies |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851659148 PECOS PAC ID: 5991969875 Enrollment ID: I20120605000205 |
| Provider Name | Dennis Starr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477727816 PECOS PAC ID: 2860658630 Enrollment ID: I20120723000763 |
| Provider Name | Kristen A Okeefe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609121086 PECOS PAC ID: 3274780549 Enrollment ID: I20120822000452 |
| Provider Name | Lynn Petras |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710059340 PECOS PAC ID: 6305096637 Enrollment ID: I20121023000568 |
| Provider Name | Tiffany L Yandell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538408372 PECOS PAC ID: 8224283551 Enrollment ID: I20130312000413 |
| Provider Name | Mary E Genung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447503420 PECOS PAC ID: 4284870346 Enrollment ID: I20130415000440 |
| Provider Name | Stephanie M Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962842278 PECOS PAC ID: 3173765658 Enrollment ID: I20130813000367 |
| Provider Name | Charlene Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235257718 PECOS PAC ID: 6608063755 Enrollment ID: I20130828000596 |
| Provider Name | Neha Barakam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942430111 PECOS PAC ID: 2163677923 Enrollment ID: I20131017000647 |
| Provider Name | Mary Haven Merkle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164406732 PECOS PAC ID: 3476557232 Enrollment ID: I20140415002297 |
| Provider Name | Lisa Carol Schweich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053739193 PECOS PAC ID: 2365667797 Enrollment ID: I20140627000521 |
| Provider Name | Megan Parton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215291661 PECOS PAC ID: 3870710940 Enrollment ID: I20140813001832 |
| Provider Name | Amy S Doss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245640085 PECOS PAC ID: 6406074368 Enrollment ID: I20140905002241 |
| Provider Name | Sara L Geaslin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730598186 PECOS PAC ID: 3476773425 Enrollment ID: I20140925001861 |
| Provider Name | Wesley S Kaney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437252848 PECOS PAC ID: 2860613791 Enrollment ID: I20141017002055 |
| Provider Name | Kyong-a B Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245649110 PECOS PAC ID: 8729200761 Enrollment ID: I20141107000151 |
| Provider Name | Veliska J Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194925404 PECOS PAC ID: 5991027286 Enrollment ID: I20141121001446 |
| Provider Name | Frederick Paul Clayton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992945745 PECOS PAC ID: 5193954196 Enrollment ID: I20141201000323 |
| Provider Name | Clifford Williamson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154562304 PECOS PAC ID: 9638495963 Enrollment ID: I20150304002320 |
| Provider Name | Heather M Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578968566 PECOS PAC ID: 4385960228 Enrollment ID: I20150311001849 |
| Provider Name | Lindsey Nicole Lattimore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518360874 PECOS PAC ID: 5890012470 Enrollment ID: I20150318002461 |
| Provider Name | Lori L Murdock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225436942 PECOS PAC ID: 4880911031 Enrollment ID: I20150326001783 |
| Provider Name | Melanie D Calvarese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861899312 PECOS PAC ID: 6709104565 Enrollment ID: I20150408001038 |
| Provider Name | Steven Matthew Fitzgerald |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942462098 PECOS PAC ID: 9032437488 Enrollment ID: I20150414002374 |
| Provider Name | Debalina Das |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639456866 PECOS PAC ID: 0446562730 Enrollment ID: I20150629002125 |
| Provider Name | Bridget D Hurt-hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285971366 PECOS PAC ID: 6406169465 Enrollment ID: I20150720002175 |
| Provider Name | Rebecca West |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760728604 PECOS PAC ID: 4880907740 Enrollment ID: I20150721002091 |
| Provider Name | Lori B Ogle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477956076 PECOS PAC ID: 6002120243 Enrollment ID: I20150803000351 |
| Provider Name | Amy Lawrence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740523620 PECOS PAC ID: 8729394226 Enrollment ID: I20150828001340 |
| Provider Name | Ann Graham Parker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164838058 PECOS PAC ID: 9638314578 Enrollment ID: I20150831002436 |
| Provider Name | Becca J Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124387857 PECOS PAC ID: 5698931954 Enrollment ID: I20150921002368 |
| Provider Name | Kristy Renee Houghton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023485190 PECOS PAC ID: 7719295971 Enrollment ID: I20151007003285 |
| Provider Name | Robyn Lovell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417382151 PECOS PAC ID: 6709195837 Enrollment ID: I20151012001697 |
| Provider Name | Jennifer Burleson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568831550 PECOS PAC ID: 0941501837 Enrollment ID: I20151218000062 |
| Provider Name | Rakesh Amin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437445475 PECOS PAC ID: 6002050010 Enrollment ID: I20151223000752 |
| Provider Name | Jacqueline Chapman North |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609803550 PECOS PAC ID: 0446243497 Enrollment ID: I20160104000919 |
| Provider Name | Corey B Konemann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043674930 PECOS PAC ID: 1052610623 Enrollment ID: I20160503001600 |
| Provider Name | Jose Casiano |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609966092 PECOS PAC ID: 8628377181 Enrollment ID: I20160504002021 |
| Provider Name | Monica L Newton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164801924 PECOS PAC ID: 6002109261 Enrollment ID: I20160726000453 |
| Provider Name | Cassie Jeanette Meadows |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114379625 PECOS PAC ID: 7911294236 Enrollment ID: I20160929001309 |
| Provider Name | Janet L Zarzour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003362633 PECOS PAC ID: 1052609435 Enrollment ID: I20161018001935 |
| Provider Name | Laura Casey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790230183 PECOS PAC ID: 9032497029 Enrollment ID: I20161026000819 |
| Provider Name | Nikki D. Vaughn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366992851 PECOS PAC ID: 1759660426 Enrollment ID: I20161121001177 |
| Provider Name | Stacey Joyce Hubbard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811379639 PECOS PAC ID: 7911214689 Enrollment ID: I20161129002359 |
| Provider Name | Ibis D. Nunez-santiago |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871614420 PECOS PAC ID: 7113165606 Enrollment ID: I20161219001609 |
| Provider Name | Miranda Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124560487 PECOS PAC ID: 7416239215 Enrollment ID: I20170130002708 |
| Provider Name | Rachel Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538617923 PECOS PAC ID: 6305129123 Enrollment ID: I20170201002063 |
| Provider Name | Theresa Ann Groomes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134666191 PECOS PAC ID: 5092090985 Enrollment ID: I20170315001466 |
| Provider Name | Jennifer Aileen Correll |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457545402 PECOS PAC ID: 5597986497 Enrollment ID: I20170418002387 |
| Provider Name | Debra E Jacks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770611709 PECOS PAC ID: 1052698115 Enrollment ID: I20170427002522 |
| Provider Name | Elizabeth Illenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295263192 PECOS PAC ID: 8022387661 Enrollment ID: I20170712004157 |
| Provider Name | Sarah Elisabeth Witkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144744947 PECOS PAC ID: 7517231160 Enrollment ID: I20170920000835 |
| Provider Name | Sravani V Mehta |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1902127582 PECOS PAC ID: 5395967400 Enrollment ID: I20170921001656 |
| Provider Name | Paul M Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346766169 PECOS PAC ID: 8628343548 Enrollment ID: I20171003006204 |
| Provider Name | Sarah Elizabeth Wellman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306170410 PECOS PAC ID: 0840411021 Enrollment ID: I20171206002755 |
| Provider Name | Regina G Hensley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518407121 PECOS PAC ID: 0244590438 Enrollment ID: I20180208000833 |
| Provider Name | Rebecca A Green |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700328796 PECOS PAC ID: 1355606278 Enrollment ID: I20180524001611 |
| Provider Name | Mark Sah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346685260 PECOS PAC ID: 5799035259 Enrollment ID: I20180904000785 |
| Provider Name | Alicia Emery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114419728 PECOS PAC ID: 4789934142 Enrollment ID: I20180905002005 |
| Provider Name | Keisha Ladona Bean |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245263946 PECOS PAC ID: 4284986852 Enrollment ID: I20181009002302 |
| Provider Name | Alysen M Carter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194110346 PECOS PAC ID: 4880941814 Enrollment ID: I20181108002876 |
| Provider Name | Tika Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922505569 PECOS PAC ID: 2163776428 Enrollment ID: I20181126003889 |
| Provider Name | Sabrina Jo Grubbs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417033002 PECOS PAC ID: 7012958531 Enrollment ID: I20190110002434 |
| Provider Name | Jlee Kimes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831551852 PECOS PAC ID: 4981983251 Enrollment ID: I20190123000455 |
| Provider Name | Korevina Lasha Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184288938 PECOS PAC ID: 1951637065 Enrollment ID: I20190726002919 |
| Provider Name | Holly A Parvin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366908980 PECOS PAC ID: 9335476506 Enrollment ID: I20190809002562 |
| Provider Name | Madison Gray Gurley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912569989 PECOS PAC ID: 0446587646 Enrollment ID: I20190812000581 |
| Provider Name | Denise Foster |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225384100 PECOS PAC ID: 6002063666 Enrollment ID: I20190817000326 |
| Provider Name | Christopher Z Witkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801448584 PECOS PAC ID: 7618206707 Enrollment ID: I20190916002228 |
| Provider Name | Kelly Hyder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245798107 PECOS PAC ID: 4183954647 Enrollment ID: I20190925002941 |
| Provider Name | Sarah Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588218119 PECOS PAC ID: 8527398650 Enrollment ID: I20191002002480 |
| Provider Name | Jodi L Brantley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497302814 PECOS PAC ID: 4183955784 Enrollment ID: I20191014000390 |
| Provider Name | Mercedes Kalt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730695180 PECOS PAC ID: 6305178633 Enrollment ID: I20191105003284 |
| Provider Name | Lynsey Danae Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568013266 PECOS PAC ID: 5395178081 Enrollment ID: I20191211001114 |
| Provider Name | Melody Felts Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487135026 PECOS PAC ID: 4385079086 Enrollment ID: I20200126000038 |
| Provider Name | Charledria Mcgee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801431721 PECOS PAC ID: 0941637631 Enrollment ID: I20200218002380 |
| Provider Name | Megan Elizabeth Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730739442 PECOS PAC ID: 3274960307 Enrollment ID: I20200228002398 |
| Provider Name | Derick Reedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427684562 PECOS PAC ID: 8224468236 Enrollment ID: I20200415000692 |
| Provider Name | Diane Weis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740816933 PECOS PAC ID: 3476983008 Enrollment ID: I20200423000730 |
| Provider Name | Adam E Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154781623 PECOS PAC ID: 2567733389 Enrollment ID: I20200519001003 |
| Provider Name | Ashlee Elizabeth Montgomery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538781216 PECOS PAC ID: 6002230562 Enrollment ID: I20200717000164 |
| Provider Name | Parul V Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194347658 PECOS PAC ID: 6800210238 Enrollment ID: I20200720000153 |
| Provider Name | Marian Bryce |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720001811 PECOS PAC ID: 5890837314 Enrollment ID: I20200810001921 |
| Provider Name | Amy Shupe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144845611 PECOS PAC ID: 8426476805 Enrollment ID: I20200916003172 |
| Provider Name | Justin Cole Meredith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033733605 PECOS PAC ID: 5991115487 Enrollment ID: I20201112001744 |
| Provider Name | Erika Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295388379 PECOS PAC ID: 3779916531 Enrollment ID: I20210414001072 |
| Provider Name | Eric Allan Helm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639638323 PECOS PAC ID: 9537496088 Enrollment ID: I20210426002333 |
| Provider Name | Juanchichos T Ventura |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205998366 PECOS PAC ID: 7416969506 Enrollment ID: I20210603001237 |
| Provider Name | Brittany Huskey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841864782 PECOS PAC ID: 1658773601 Enrollment ID: I20210713002534 |
| Provider Name | Morgan Durant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487224051 PECOS PAC ID: 6800299314 Enrollment ID: I20210721002608 |
| Provider Name | Melissa Ann Mcnutt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154921120 PECOS PAC ID: 7719380807 Enrollment ID: I20210727003057 |
| Provider Name | Richard F Thompson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376551036 PECOS PAC ID: 8325094857 Enrollment ID: I20210903001025 |
| Provider Name | Jennifer Friley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114522521 PECOS PAC ID: 3971901497 Enrollment ID: I20211013001039 |
| Provider Name | Alexandra K Drake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245531987 PECOS PAC ID: 3971779091 Enrollment ID: I20211119002525 |
| Provider Name | Kaitlyn Eldridge Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376207886 PECOS PAC ID: 4587054473 Enrollment ID: I20211208002194 |
| Provider Name | Donielle Dawn Brinkley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801496229 PECOS PAC ID: 6800288986 Enrollment ID: I20220124000042 |
| Provider Name | Ashlee Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003334798 PECOS PAC ID: 2264787704 Enrollment ID: I20220211000124 |
| Provider Name | Lisa Leclair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104399880 PECOS PAC ID: 1557604493 Enrollment ID: I20220215001771 |
| Provider Name | Herneaschia Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437819984 PECOS PAC ID: 9830583525 Enrollment ID: I20220223000240 |
| Provider Name | Lauren T Hudson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619630217 PECOS PAC ID: 1153715305 Enrollment ID: I20220303001917 |
| Provider Name | Susan Gross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932116266 PECOS PAC ID: 1052395399 Enrollment ID: I20220310000676 |
| Provider Name | Chlin Tennyson-yemm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629713375 PECOS PAC ID: 8325425762 Enrollment ID: I20220524002156 |
| Provider Name | Lauren Mcclain Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316682750 PECOS PAC ID: 4789065574 Enrollment ID: I20220726001327 |
| Provider Name | Schuyler Lucio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346669090 PECOS PAC ID: 0446634026 Enrollment ID: I20220831000715 |
| Provider Name | Miranda N Elliott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669048294 PECOS PAC ID: 8820473499 Enrollment ID: I20220917000089 |
| Provider Name | Laney Poole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497365613 PECOS PAC ID: 9436548534 Enrollment ID: I20220929001738 |
| Provider Name | Jacqueline R Smartt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285197426 PECOS PAC ID: 4486030285 Enrollment ID: I20221003000085 |
| Provider Name | Jennifer Huffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083334593 PECOS PAC ID: 4183000599 Enrollment ID: I20221007000551 |
| Provider Name | Megan Felts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427770965 PECOS PAC ID: 0547646838 Enrollment ID: I20221011001282 |
| Provider Name | Kesha Torentia Casseus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699401869 PECOS PAC ID: 7810363868 Enrollment ID: I20221017003391 |
| Provider Name | Alexis Jade Alley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346961166 PECOS PAC ID: 6507232402 Enrollment ID: I20221018001916 |
| Provider Name | Crystal Renee Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104540517 PECOS PAC ID: 9638547482 Enrollment ID: I20221129000363 |
| Provider Name | Melsah Riley-hazel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316282494 PECOS PAC ID: 3779711577 Enrollment ID: I20221202001682 |
| Provider Name | Lisa Ann Jaycox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053685362 PECOS PAC ID: 5991073850 Enrollment ID: I20221207002515 |
| Provider Name | Tammy A Buchanon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477102713 PECOS PAC ID: 4385015791 Enrollment ID: I20230123002030 |
| Provider Name | Sameera Natarajan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659804417 PECOS PAC ID: 9436420528 Enrollment ID: I20230302002380 |
| Provider Name | Christy Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821705575 PECOS PAC ID: 4183647977 Enrollment ID: I20230303002316 |
| Provider Name | Susan M Kirk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285737114 PECOS PAC ID: 1355445917 Enrollment ID: I20230313000296 |
| Provider Name | Vera Ikekhide |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861190217 PECOS PAC ID: 9032584669 Enrollment ID: I20230412001156 |
| Provider Name | Lindsey C Baxter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043929425 PECOS PAC ID: 0648638205 Enrollment ID: I20230614002511 |
| Provider Name | Janet Mcnamara Houck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902854912 PECOS PAC ID: 7416965322 Enrollment ID: I20230724002502 |
| Provider Name | Shenella Carlisle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235641267 PECOS PAC ID: 8921353400 Enrollment ID: I20230726002179 |
| Provider Name | Nyla Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477071330 PECOS PAC ID: 3971879834 Enrollment ID: I20230821003042 |
| Provider Name | Tammy Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922707306 PECOS PAC ID: 1759744196 Enrollment ID: I20230831003704 |
| Provider Name | Sagar Dhanawade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669992681 PECOS PAC ID: 1951673714 Enrollment ID: I20230928003646 |
| Provider Name | Jennifer Arthur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528843224 PECOS PAC ID: 1951756063 Enrollment ID: I20231010002160 |
| Provider Name | Angela Cremeans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821784166 PECOS PAC ID: 3779938568 Enrollment ID: I20231013002913 |
| Provider Name | Brenda Carr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134862725 PECOS PAC ID: 1658753397 Enrollment ID: I20231205000995 |
| Provider Name | Tasleem Pierce |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649959826 PECOS PAC ID: 3779939400 Enrollment ID: I20240117003130 |
| Provider Name | Ashley Weiss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376153791 PECOS PAC ID: 6103231725 Enrollment ID: I20240306001300 |
| Provider Name | Natascha Atkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982468484 PECOS PAC ID: 5092152975 Enrollment ID: I20240327002799 |
| Provider Name | Suzanne Hope Sikes-thurman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477219665 PECOS PAC ID: 4587002399 Enrollment ID: I20240329000201 |
| Provider Name | Rachel B Smith-langley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265834998 PECOS PAC ID: 5799007779 Enrollment ID: I20240521003873 |
| Provider Name | Michelle Lee Hale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740654714 PECOS PAC ID: 5991248361 Enrollment ID: I20240614000147 |
| Provider Name | Esther Chelladurai |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730956251 PECOS PAC ID: 6709323207 Enrollment ID: I20240801002946 |
| Provider Name | Peggy Ann Jelks |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1700457140 PECOS PAC ID: 3779021688 Enrollment ID: I20240809002318 |
| Provider Name | Kelly Taylor Treadway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316773419 PECOS PAC ID: 5395270144 Enrollment ID: I20241203001529 |
| Provider Name | Christina Perdue |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235532177 PECOS PAC ID: 2062948870 Enrollment ID: I20241203004424 |
| Provider Name | Brian J Rosenhein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982678058 PECOS PAC ID: 6103829312 Enrollment ID: I20241209000787 |
A Loving Hand Home Care Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 879 Highway 126 Ste B, Bristol, TN 37620 Phone: 423-737-7645 | |
Highlands Mindcare, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 28 Midway St., Suite 1, Bristol, TN 37620 Phone: 423-764-2165 Fax: 423-217-0779 | |
Brandon M. Cole, Lpc, Mhsp, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 739 Bluff City Hwy Ste 8, Bristol, TN 37620 Phone: 423-444-5169 Fax: 423-217-1069 | |
Ernst Psychiatric Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 5th St Ste 340, Shelby Square, Bristol, TN 37620 Phone: 423-990-2100 Fax: 423-652-2884 |