Individual provider Active NPI

Lauren Elizabeth Mann, PA-C

  • Physician Assistant
  • Maryville, TN
National Provider Identifier
1184464208
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
108 Keller LN
Maryville, TN 37801-6201
Phone
(865) 205-9505
NPI assigned
May 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

108 Keller LN
Maryville, TN 37801-6201

Mailing address

3107 Starling Dr
Maryville, TN 37803-6910
Phone (904) 460-8517

Other practice location 1

1787 Veterans Blvd
Sevierville, TN 37862-6945
Phone (865) 428-2773

Other practice location 2

6606 Clinton Hwy
Knoxville, TN 37912-1016
Phone (865) 429-4008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250227000335 TN Practitioner - Physician Assistant 7416477955 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chuc, LLCGroup PAC ID 3375505134, 32 clinicians

Practice addresses (Care Compare)

108 Keller LN
Maryville, TN 37801-6201
Phone (865) 205-9505

117 Gill St
Alcoa, TN 37701-2672
Phone (865) 982-3409

Hospital & facility affiliations

  • Roane Medical Center Hospital, Harriman, TN, CCN 440031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6065TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Abercrombie Radiological Consultants Inc Past Accepting new patients

Organizations & group practices 4

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1184464208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 STARLING DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378036910",
            "telephone_number": "904-460-8517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 KELLER LN",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378016201",
            "telephone_number": "865-205-9505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1787 Veterans Blvd",
            "address_purpose": "LOCATION",
            "city": "Sevierville",
            "state": "TN",
            "postal_code": "378626945",
            "country_code": "US",
            "telephone_number": "865-428-2773",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6606 Clinton Hwy",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379121016",
            "country_code": "US",
            "telephone_number": "865-429-4008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANN",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.