| Visavis Health Care Medical Group Of Tn Pllc | |
|
136 Davis Ln La Follette TN 37766-3118 | |
| (929) 491-7333 | |
| Not Available |
| Full Name | Visavis Health Care Medical Group Of Tn Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 136 Davis Ln, La Follette, Tennessee |
| Authorized Official Name and Position | Rekha Bhandari (OWNER) |
| Authorized Official Contact | 2127346621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Visavis Health Care Medical Group Of Tn Pllc 831 Bedford Ave Ste 530 Brooklyn NY 11205-2801 Ph: () - | Visavis Health Care Medical Group Of Tn Pllc 136 Davis Ln La Follette TN 37766-3118 Ph: (929) 491-7333 |
| NPI Number | 1407639172 |
|---|---|
| Provider Enumeration Date | 08/16/2023 |
| Last Update Date | 09/08/2023 |
| Medicare PECOS PAC ID | 1557717683 |
|---|---|
| Medicare Enrollment ID | O20231026001239 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407639172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jennifer Jaris Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821012923 PECOS PAC ID: 0345200085 Enrollment ID: I20041016000087 |
| Provider Name | Irmalynn Mooneyham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225470057 PECOS PAC ID: 4880838440 Enrollment ID: I20130920000450 |
| Provider Name | Tiffany Glass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659819944 PECOS PAC ID: 0941578058 Enrollment ID: I20170614000680 |
| Provider Name | Bettina Bellamy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891364774 PECOS PAC ID: 4587067764 Enrollment ID: I20210726002360 |
| Provider Name | Jasmine Marshall-anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205504180 PECOS PAC ID: 8426435454 Enrollment ID: I20220513000536 |
| Provider Name | Jessica T Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821675158 PECOS PAC ID: 5395145593 Enrollment ID: I20230523000418 |
| Provider Name | Kristin Rainelle Curcio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538195276 PECOS PAC ID: 9234174343 Enrollment ID: I20230927003523 |
| Provider Name | Derek Anthony Harpole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235771874 PECOS PAC ID: 3779914965 Enrollment ID: I20231108002622 |
| Provider Name | Jenna Michelle Koepke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851848352 PECOS PAC ID: 8426346826 Enrollment ID: I20231113000771 |
| Provider Name | Ana Hubert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528370897 PECOS PAC ID: 6406080613 Enrollment ID: I20231113003430 |
| Provider Name | Jerel Keith Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750843876 PECOS PAC ID: 4688008394 Enrollment ID: I20240131003128 |
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