Chestnut Health Of Tennessee Pllc | |
2830 Highway 394 Blountville TN 37617-5577 | |
(423) 274-6191 | |
(703) 649-6188 |
Full Name | Chestnut Health Of Tennessee Pllc |
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Speciality | Internal Medicine |
Location | 2830 Highway 394, Blountville, Tennessee |
Authorized Official Name and Position | Omair Siraj (OWNER) |
Authorized Official Contact | 7039648199 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Chestnut Health Of Tennessee Pllc Po Box 904 Bedford Park IL 60499-0904 Ph: (703) 964-8199 | Chestnut Health Of Tennessee Pllc 2830 Highway 394 Blountville TN 37617-5577 Ph: (423) 274-6191 |
NPI Number | 1730928706 |
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Provider Enumeration Date | 05/21/2024 |
Last Update Date | 06/18/2024 |
Medicare PECOS PAC ID | 8123567633 |
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Medicare Enrollment ID | O20240828003578 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730928706 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Wendy Swiney |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669708848 PECOS PAC ID: 5597809749 Enrollment ID: I20100225000668 |
Provider Name | Allison M Susman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629585559 PECOS PAC ID: 3577819366 Enrollment ID: I20180710000545 |
Provider Name | Casey Mae Bates |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720709744 PECOS PAC ID: 1254702897 Enrollment ID: I20230119000509 |
Provider Name | Kuljit Singh Kapur |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1831399518 PECOS PAC ID: 2860649985 Enrollment ID: I20240904000740 |
Provider Name | Megan Mcmahon |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902627532 PECOS PAC ID: 3971039918 Enrollment ID: I20241213000692 |