NPIMap

Organization Active NPI

App of Tennessee Ed, PLLC

  • Emergency Medicine Physician
  • Maryville, TN
National Provider Identifier
1003230236
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
APP OF TENNESSEE ED, PLLC
Practice address
907 E Lamar Alexander Pkwy
Maryville, TN 37804
Phone
(865) 983-7211
NPI assigned
Feb 7, 2014
Last updated
Jan 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James Grimes
Title
Cfo
Phone
(615) 551-6611

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Emergency Medicine Physician 207P00000X Primary
Physical Therapy Assistant 225200000X

Addresses

Primary practice location

907 E Lamar Alexander Pkwy
Maryville, TN 37804

Mailing address

PO Box 31957
Clarksville, TN 37040-0033

Other practice location 1

2000 Brookside Dr
Kingsport, TN 37660-4627
Phone (423) 857-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140506000159 TN Part B Supplier - Clinic/Group Practice 8123251766 Receives reassigned benefits from 513 practitioners
Practice locations: Fayetteville, TN; Tullahoma, TN; Springfield, TN; Powell, TN; Newport, TN; Maryville, TN; Knoxville, TN; Jefferson City, TN…
O20180814002326 VA Part B Supplier - Clinic/Group Practice 8123251766 Receives reassigned benefits from 65 practitioners
Practice locations: Big Stone Gap, VA

National Provider Directory

National Provider Directory

Locations

401 Sewell Dr
Sparta, TN 38583
Phone (931) 738-2164

Practitioners & affiliated clinicians

Practitioners 572

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 572

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1003230236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31957",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370400033",
            "fax_number": "205-313-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "37804",
            "telephone_number": "865-983-7211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Brookside Dr",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376604627",
            "country_code": "US",
            "telephone_number": "423-857-7000",
            "fax_number": "629-216-0568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "APP OF TENNESSEE ED, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-07",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A",
        "authorized_official_last_name": "GRIMES",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "615-551-6611"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.