Provider Demographics
NPI:1497976534
Name:TENNESSEE ORTHOPAEDIC CLINICS PC
Entity Type:Organization
Organization Name:TENNESSEE ORTHOPAEDIC CLINICS PC
Other - Org Name:TENNESSEE ORTHOPAEDIC ALLIANCE
Other - Org Type:Other Name
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:ZENA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-694-0062
Mailing Address - Street 1:9129 CROSS PARK DR STE 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4505
Mailing Address - Country:US
Mailing Address - Phone:865-694-7725
Mailing Address - Fax:865-694-7907
Practice Address - Street 1:1819 CLINCH AVE STE 106
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2435
Practice Address - Country:US
Practice Address - Phone:865-633-0259
Practice Address - Fax:865-524-5047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20611207X00000X
225100000X, 261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1538153937OtherNPI
TN3376148Medicare PIN
0677340013Medicare NSC
TN3376145Medicare PIN