Individual provider Active NPI

Erica K Burnette, LCSW

  • Clinical Social Worker
  • Lenoir City, TN
National Provider Identifier
1114045689
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4974 Issued in TN
Practice address
1475 Simpson Rd W Ste 2
Lenoir City, TN 37771-6686
Phone
(865) 635-0242
Fax
(865) 635-0244
NPI assigned
Mar 26, 2007
Last updated
Sep 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4974 TN Primary

Addresses

Primary practice location

1475 Simpson Rd W Ste 2
Lenoir City, TN 37771-6686

Mailing address

201 W Springdale Ave
Knoxville, TN 37917-5158
Phone (865) 637-9711

Other practice location 1

100 Adams Ln
Oak Ridge, TN 37830-4909
Phone (865) 483-7743

Other identifiers 1

IdentifierTypeStateIssuer
1507993MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4974TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Parkwest Medical Center Past Accepting new patients
Helen Ross McNabb Center PastSince Aug 7, 2017 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1114045689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W SPRINGDALE AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379175158",
            "telephone_number": "865-637-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 SIMPSON RD W STE 2",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377716686",
            "telephone_number": "865-635-0242",
            "fax_number": "865-635-0244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Adams Ln",
            "address_purpose": "LOCATION",
            "city": "Oak Ridge",
            "state": "TN",
            "postal_code": "378304909",
            "country_code": "US",
            "telephone_number": "865-483-7743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNETTE",
        "first_name": "ERICA",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "4974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1507993",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenoir City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; 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.