David E Biddle, NP
Individual provider Active NPI Nurse Practitioner · Maryville, TN
NPI 1023218211 · NPPES record last updated Jun 9, 2023
Key facts
- NPI
- 1023218211
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 12836 (TN)
- Practice address
- 907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015 - Phone
- (865) 980-4897
- Fax
- (865) 977-4722
- NPI assigned
- Jul 25, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070913000375 | TN | Practitioner - Nurse Practitioner | 6103910732 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12836 | TN | MD | General Practice Dentistry |
| 110480 | TN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CS Pacs 3 Southeast, LLC | Current |
Accepting new patients | |
| NV Pacs 2 LLC | Current |
Accepting new patients | |
| Ipc Pac Healthcare Services of Tennessee PC | Nurse Practitioner | Current |
Accepting new patients |
Locations
880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 110480 | TN | |
| Nurse Practitioner | 363L00000X | 12836 | TN | Yes |
Addresses
Primary practice location
907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015
Mailing address
103 W Broadway Ave
Maryville, TN 37801-4703
Phone (865) 273-1752
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110480 | Other | TN | RN LICENSE |
| 12836 | Other | TN | APN LICNESE |
| 3341244 | Medicaid | TN |
Other providers in Maryville, TN
- Bess & Company Inc
- Best Weigh Weight Loss Center LLC
- Mary Elizabeth Best
- Mohammed A Bhatti
- Melanie Bibee
- Amanda E Bilbrey
- Billingsley Eye Care Corporation
- Sharon M Billingsley
- Samantha Denali Bingham
- Chelsey Birch
All providers in Maryville, TN · Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.