NPIMap

Organization Active NPI

M3C

Doing business as Mission Mobile Medical Care

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1295366037
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
M3C
Doing business as
Mission Mobile Medical Care
Practice address
9041 Executive Park Dr Ste 250
Knoxville, TN 37923-4657
Phone
(865) 298-1500
Fax
(865) 298-1501
NPI assigned
Jan 30, 2020
Last updated
Aug 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Authorized official

Name
Mr. Seth D White
Title
Manager
Phone
(270) 316-5214

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

9041 Executive Park Dr Ste 250
Knoxville, TN 37923-4657

Mailing address

9041 Executive Park Dr Ste 250
Knoxville, TN 37923-4657
Phone (865) 298-1502

Other names 1

  • Mission Mobile Medical Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200422000775 TN Part B Supplier - Clinic/Group Practice 3375973936 Receives reassigned benefits from 6 practitioners
Practice locations: Knoxville, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1295366037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9041 EXECUTIVE PARK DR STE 250",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234657",
            "telephone_number": "865-298-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9041 EXECUTIVE PARK DR STE 250",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234657",
            "telephone_number": "865-298-1500",
            "fax_number": "865-298-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M3C",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "SETH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "270-316-5214",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Mobile Medical Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mission Mobile Medical Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.