Active NPI
Pediatric Consultants at Cedar Bluff
- Pediatrics Physician
- Knoxville, TN
National Provider Identifier
1316118714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- PEDIATRIC CONSULTANTS AT CEDAR BLUFF
- Practice address
- 9333 Park West Blvd Ste 104
Knoxville, TN 37923-4305 - Phone
- (865) 560-8778
- Fax
- (865) 394-6599
- NPI assigned
- Mar 13, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tonya Owens
- Title
- Manager
- Phone
- (865) 560-8778
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | TN | Primary |
Addresses
Primary practice location
9333 Park West Blvd Ste 104
Knoxville, TN 37923-4305
Mailing address
Dept 888214
Knoxville, TN 37995-8214
Phone (865) 670-6199
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q013042 | Medicaid | TN |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D1077999 | Pediatric Consultants of Cedar Bluff Inc | Certificate of waiver | Dec 25, 2027 |
National Provider Directory
National Provider DirectoryLocations
320 N Park 40 Blvd
Ste B
Knoxville, TN 37923
Phone (865) 690-6660
Dept 888214
Knoxville, TN 37995
9333 Park West Blvd
Ste 108A
Knoxville, TN 37923
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatrics Physician
- Knoxville, TN
- NPI 1407941164
-
- Pediatric Clinical Nurse Specialist
- Knoxville, TN
- NPI 1396910618
-
- Neurology Physician
- Knoxville, TN
- NPI 1699773747
-
- Pediatric Nurse Practitioner
- Maynardville, TN
- NPI 1134568728
-
- Family Nurse Practitioner
- Knoxville, TN
- NPI 1780447664
-
- Physician Assistant
- Knoxville, TN
- NPI 1942590625
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205366400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1509494400000",
"number": "1316118714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DEPT 888214",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379958214",
"telephone_number": "865-670-6199",
"fax_number": "865-670-6198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9333 PARK WEST BLVD STE 104",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379234305",
"telephone_number": "865-560-8778",
"fax_number": "865-394-6599"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEDIATRIC CONSULTANTS AT CEDAR BLUFF",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-13",
"last_updated": "2017-11-01",
"status": "A",
"authorized_official_last_name": "OWENS",
"authorized_official_first_name": "TONYA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "865-560-8778"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "TN",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q013042",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
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 Nov 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.