NPIMap

Organization Active NPI

Mission Hope Pediatric Therapy LLC

  • Speech-Language Pathologist
  • Maynardville, TN
National Provider Identifier
1013553304
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
MISSION HOPE PEDIATRIC THERAPY LLC
Practice address
3925 Maynardville Hwy Ste 1
Maynardville, TN 37807-3552
Phone
(865) 585-1307
NPI assigned
Nov 21, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Authorized official

Name
Brittany BucknerNPI 1265913461
Title
Owner
Phone
(865) 585-1307

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

3925 Maynardville Hwy Ste 1
Maynardville, TN 37807-3552

Mailing address

3925 Maynardville Hwy Ste 1
Maynardville, TN 37807-3552

Other practice location 1

10579 Cedar Grove Rd Ste 120
Smyrna, TN 37167-8385
Phone (615) 462-6233

Other practice location 2

514 Cross St Ste B
New Tazewell, TN 37825-7155
Phone (423) 441-1276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200204002741 TN Part B Supplier - Clinic/Group Practice 3779919048 Receives reassigned benefits from 7 practitioners
Practice locations: Smyrna, TN; New Tazewell, TN; Maynardville, TN

National Provider Directory

National Provider Directory

Locations

3925 Maynardville Hwy
#1
Maynardville, TN 37807
Phone (865) 333-4673

514 Cross St
Ste B
New Tazewell, TN 37825
Phone (423) 441-1276

10579 Cedar Grove Rd
Ste 120
Smyrna, TN 37167
Phone (615) 462-6233

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787702400000",
    "number": "1013553304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 MAYNARDVILLE HWY STE 1",
            "city": "MAYNARDVILLE",
            "state": "TN",
            "postal_code": "378073552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 MAYNARDVILLE HWY STE 1",
            "city": "MAYNARDVILLE",
            "state": "TN",
            "postal_code": "378073552",
            "telephone_number": "865-585-1307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10579 Cedar Grove Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "TN",
            "postal_code": "371678385",
            "country_code": "US",
            "telephone_number": "615-462-6233",
            "fax_number": "865-951-7281",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "514 Cross St Ste B",
            "address_purpose": "LOCATION",
            "city": "New Tazewell",
            "state": "TN",
            "postal_code": "378257155",
            "country_code": "US",
            "telephone_number": "423-441-1276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MISSION HOPE PEDIATRIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-21",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A",
        "authorized_official_last_name": "BUCKNER",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-585-1307"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maynardville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.