| Smoky Mountain Primary Care | |
|
1620 E Lamar Alexander Pkwy Maryville TN 37804-6205 | |
| (865) 405-1740 | |
| Not Available |
| Full Name | Smoky Mountain Primary Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1620 E Lamar Alexander Pkwy, Maryville, Tennessee |
| Authorized Official Name and Position | Kimberly L Chambers (OWNER) |
| Authorized Official Contact | 8564051740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smoky Mountain Primary Care 1620 E Lamar Alexander Pkwy Maryville TN 37804-6205 Ph: (865) 405-1740 | Smoky Mountain Primary Care 1620 E Lamar Alexander Pkwy Maryville TN 37804-6205 Ph: (865) 405-1740 |
| NPI Number | 1932602448 |
|---|---|
| Provider Enumeration Date | 03/10/2018 |
| Last Update Date | 03/10/2018 |
| Medicare PECOS PAC ID | 6002178050 |
|---|---|
| Medicare Enrollment ID | O20180403000485 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932602448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 16537 (Tennessee) | Primary |
| Provider Name | Whitaker M Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003827205 PECOS PAC ID: 8527075647 Enrollment ID: I20100318000245 |
| Provider Name | Kimberly Lynn Chambers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982977294 PECOS PAC ID: 6002078995 Enrollment ID: I20120511000087 |
| Provider Name | Kara White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114529492 PECOS PAC ID: 3173936473 Enrollment ID: I20210105002974 |
| Provider Name | Tamara Zelch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588273098 PECOS PAC ID: 7810304870 Enrollment ID: I20210318002853 |
| Provider Name | Kayla C Holt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205557964 PECOS PAC ID: 2769852698 Enrollment ID: I20230110001477 |
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