Individual provider Active NPI

Penelope Fattebert

  • Acupuncturist
  • Oak Ridge, TN
National Provider Identifier
1215549175
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
356 Issued in TN
Practice address
103 W Tennessee Ave
Oak Ridge, TN 37830-6502
Phone
(865) 333-5811
NPI assigned
Aug 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 356 TN Primary

Addresses

Primary practice location

103 W Tennessee Ave
Oak Ridge, TN 37830-6502

Mailing address

10406 Jackson Oaks Way Ste a
Knoxville, TN 37922-3338

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
356TNMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1215549175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10406 JACKSON OAKS WAY STE A",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W TENNESSEE AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306502",
            "telephone_number": "865-333-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATTEBERT",
        "first_name": "PENELOPE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "TN",
            "license": "356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.