MMDS of Knoxville, LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

MMDS OF KNOXVILLE, LLC

Practice address

710 Mabry Hood Rd
Knoxville, TN 37932-2661

Phone

(865) 671-6637

NPI assigned

Mar 29, 2006

Organization subpart

No

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

Authorized official

Name

Jeffrey G Tjader

Title

Owner

Phone

(823) 250-2830

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1336100445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 MABRY HOOD RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379322661",
            "telephone_number": "865-671-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 MABRY HOOD RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379322661",
            "telephone_number": "865-671-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMDS OF KNOXVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "TJADER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "823-250-2830"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3044463",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "3404463",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Walker Mize, MA,CCC/SLP
• Logan Mize
• Mary Leah Mizer, PT
• Emma Mizzell, BSSW
• MJ Mental Health, LLC
• MMS Knoxville, Inc
• MNS3, PLLC
• Kyleigh Mo, M.S., CCC-SLP
• Rebecca Malone Moak, D. PH.
• Thomas Andrew Moak III, D.PH.

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.