Provider Demographics
NPI:1891880415
Name:PM&R ASSOCIATES
Entity Type:Organization
Organization Name:PM&R ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-330-9799
Mailing Address - Street 1:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37777-0580
Mailing Address - Country:US
Mailing Address - Phone:865-330-9799
Mailing Address - Fax:865-330-9759
Practice Address - Street 1:6441 DEANE HILL DRIVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919
Practice Address - Country:US
Practice Address - Phone:865-330-9799
Practice Address - Fax:865-330-9759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35462208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0717787OtherCIGNA
TN1508811Medicaid
TN100038261OtherPHP TENNCARE
TN5623220001OtherCIGNA GOVERNMENT SERVICES
TN7152403OtherAETNA
TN4104038OtherBLUE CROSS BLUE SHIELD
41663670OtherHUMANA
41663670OtherHUMANA
TNF55875Medicare UPIN
TN1508811Medicaid