East Tennessee Vein Clinic, PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

202K00000X Issued in TN

Legal business name

EAST TENNESSEE VEIN CLINIC, PC

Practice address

1344 Dowell Springs Blvd
Knoxville, TN 37909

Phone

(865) 686-0807

Fax

(865) 357-8346

NPI assigned

Apr 2, 2007

Last updated

Feb 24, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Darla Y Walker

Title

Practice Administrator

Phone

(865) 686-0507

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrea Elizabeth Kooch, PA-C

  • Physician Assistant
  • Knoxville, TN
  • NPI 1275174013
  NPD

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614124800000",
    "number": "1154442861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52333",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379502333",
            "telephone_number": "865-686-0807",
            "fax_number": "865-357-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 DOWELL SPRINGS BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37909",
            "telephone_number": "865-686-0807",
            "fax_number": "865-357-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TENNESSEE VEIN CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "DARLA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "865-686-0507"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TN",
            "license": "202K00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Tennessee Regional OB/GYN Associates PC
• East Tennessee Spine & Sport Inc
• East Tennessee Surgical Group, P.C.
• East Tennessee Urgent Care
• East Tennessee Urgent Care and Occupational Health (East Towne Urgent Care and Occupational Health)
• East Tennessee Women's Care, PC (Southest Gynecologic Oncology Associates)
• East TN Human Resource Agency
• East TN Nutrition and Wellness
• East TN Physicians Care
• East TN Women's GYN/Oncology

• Clinic/Center in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.