Southeast Tennessee Health Clinic, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SOUTHEAST TENNESSEE HEALTH CLINIC, LLC

Practice address

11039 Parkside Dr
Knoxville, TN 37934-1953

Phone

(281) 429-8526

NPI assigned

Oct 21, 2022

Organization subpart

No

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

Authorized official

Name

Welton Wayne Wilson

Title

Manager

Phone

(281) 825-8526

Specialties & licenses 1

Addresses

Tax ID family

Southeast Tennessee Health Clinic LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Southeast Tennessee Health Clinic, LLC

  • Primary Care Clinic/Center
  • Chattanooga, TN
  • NPI 1083322838
  NPD tax ID

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1154048072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16131 N ELDRIDGE PKWY STE 100",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773779130",
            "telephone_number": "832-585-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11039 PARKSIDE DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379341953",
            "telephone_number": "281-429-8526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7480 Ziegler Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374214947",
            "country_code": "US",
            "telephone_number": "423-933-2001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHEAST TENNESSEE HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WELTON",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "281-825-8526"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southeast Oral Surgery PC
• Southeast Precision Clinic of Chiropractic, PLLC
• Southeast Spine & Pain Associates LLC
• Southeast Spine and Pain Associates Inc.
• Southeast Spine and Rehab Corp.
• Southeastern Center for Fertility and Reproductive Surgery, PLLC
• Southeastern Dermatology Consultants, PC
• Southeastern Fertility Center
• Southeastern Mobile Imaging LLC
• Southeastern Occupational Pulmonary Services

• All providers in Knoxville, TN
• Primary Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.