| Northshore Group | |
|
1111 N Northshore Dr Ste South490 Knoxville TN 37919-4005 | |
| (865) 584-0171 | |
| (865) 584-0174 |
| Full Name | Northshore Group |
|---|---|
| Speciality | Psychologist |
| Location | 1111 N Northshore Dr Ste South490, Knoxville, Tennessee |
| Authorized Official Name and Position | Michael Calvin Hawthorne (PRESIDENT) |
| Authorized Official Contact | 8655840171 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northshore Group 1111 N Northshore Dr Ste South490 Knoxville TN 37919-4005 Ph: (865) 584-0171 | Northshore Group 1111 N Northshore Dr Ste South490 Knoxville TN 37919-4005 Ph: (865) 584-0171 |
| NPI Number | 1790423366 |
|---|---|
| Provider Enumeration Date | 05/24/2022 |
| Last Update Date | 09/12/2024 |
| Certification Date | 09/12/2024 |
| Medicare PECOS PAC ID | 7012374929 |
|---|---|
| Medicare Enrollment ID | O20230608001667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790423366 | NPI | - | NPPES |
| Provider Name | Michael C Hawthorne |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063427821 PECOS PAC ID: 7517925050 Enrollment ID: I20041229000960 |
| Provider Name | Anne Whitney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538218375 PECOS PAC ID: 0244403293 Enrollment ID: I20111108000123 |
| Provider Name | Edgar H Jessee |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760496624 PECOS PAC ID: 1153589726 Enrollment ID: I20120229000056 |
| Provider Name | Beverly Formby Mckee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275576209 PECOS PAC ID: 4789843665 Enrollment ID: I20120313000361 |
| Provider Name | Charles R May |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245268531 PECOS PAC ID: 0547429458 Enrollment ID: I20120313000700 |
| Provider Name | Caitlin Adele Greenwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710231964 PECOS PAC ID: 1557514346 Enrollment ID: I20130102000468 |
| Provider Name | Barbara J Godfrey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255349221 PECOS PAC ID: 0941423370 Enrollment ID: I20140603001465 |
| Provider Name | Magon Adams Shirley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518356021 PECOS PAC ID: 7113326794 Enrollment ID: I20210602000966 |
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