Organization Active NPI

Morristown Pain Consultants

  • Pain Medicine (Anesthesiology) Physician
  • Knoxville, TN
National Provider Identifier
1073605663
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
MORRISTOWN PAIN CONSULTANTS
Practice address
1124 N Broadway
Knoxville, TN 37917-6527
Phone
(865) 444-5059
Fax
(865) 540-6804
NPI assigned
Sep 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Authorized official

Name
Michael Alan Chavin, MD
Title
Medical Director
Phone
(865) 444-5059

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 32281 TN
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X TN Primary

Addresses

Primary practice location

1124 N Broadway
Knoxville, TN 37917-6527

Mailing address

1124 N Broadway
Knoxville, TN 37917-6527
Phone (865) 444-5059

Other identifiers 3

IdentifierTypeStateIssuer
3378614MedicaidTN
6455330001OtherTNMEDICARE DME PTAN
3848928MedicaidTN

Other names 1

  • Broadway Neck and Spine Doing business as

National Provider Directory

National Provider Directory

Locations

1124 N Broadway St
Knoxville, TN 37917
Phone (865) 444-5059

1639 W Morris Blvd
Morristown, TN 37813
Phone (423) 586-0341

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528675200000",
    "number": "1073605663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 N BROADWAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379176527",
            "telephone_number": "865-444-5059",
            "fax_number": "865-540-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 N BROADWAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379176527",
            "telephone_number": "865-444-5059",
            "fax_number": "865-540-6804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORRISTOWN PAIN CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2018-06-11",
        "status": "A",
        "authorized_official_last_name": "CHAVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "865-444-5059",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TN",
            "license": "32281",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3378614",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME   PTAN",
            "identifier": "6455330001",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3848928",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broadway Neck and Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.