Laraine Lieberman, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

21803 Issued in TN

Practice address

2431 Jones Bend Rd
Louisville, TN 37777-5216

Phone

(865) 970-1263

Fax

(865) 970-6334

NPI assigned

Mar 17, 2006

Last updated

Feb 21, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Laraine Lieberman Tellez Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Parkwest Medical CenterGroup PAC ID 8527965417, 58 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Parkwest Medical Center

  dba Peninsula Div Parkwest MC

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1396739165
  Medicare reassignment Care Compare group NPD
• Morristown Hamblen Hospital Association

  dba Morristown Hamblen Healthcare System

  • General Acute Care Hospital
  • Morristown, TN
  • NPI 1912997024
  Medicare reassignment NPD
• Parkwest Medical Center

  • Psychiatric Hospital Unit
  • Knoxville, TN
  • NPI 1851369243
  NPD
• Scott County Community Hospital, Inc.

  dba Big South Fork Medical Center

  • Emergency Medicine Physician
  • Oneida, TN
  • NPI 1124536990
  NPD
• Attentus of Scott County, LLC

  dba Scott County Primary Care Clinic

  • Family Nurse Practitioner
  • Oneida, TN
  • NPI 1528029683
  NPD (past)
• Morristown Hamblen Hospital Association

  dba Morristown Hamblen Healthcare System

  • Psychiatric Hospital Unit
  • Morristown, TN
  • NPI 1477602860
  NPD (past)
• Parkwest Medical Center

  dba Peninsula Lighthouse Peninsula Outpatient Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Knoxville, TN
  • NPI 1154303162
  NPD (past)
• Parkwest Medical Center

  dba Peninsula Outpatient Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Sevierville, TN
  • NPI 1508848516
  NPD (past)
• Scott County Medical Clinic Inc

  dba Scott County Imaging Center

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Oneida, TN
  • NPI 1033282405
  NPD (past)
• Village Behavioral Health, LLC

  dba Village Behavioral Health

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Louisville, TN
  • NPI 1598998619
  NPD (past)

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1336108562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130 EDMONDSON LN",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379187126",
            "telephone_number": "865-617-1121",
            "fax_number": "865-970-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 JONES BEND RD",
            "city": "LOUISVILLE",
            "state": "TN",
            "postal_code": "377775216",
            "telephone_number": "865-970-1263",
            "fax_number": "865-970-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "LARAINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "21803",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TN",
            "license": "21803",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "TN",
            "license": "21803",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3095656",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARAINE",
            "last_name": "TELLEZ",
            "middle_name": "LIEBERMAN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonathan Shreve Kamar, PA-C
• Kci USA, Inc. (Solventum Advanced Wound Care)
• Brett Matthew Kleinhans, LPC-MHSP
• Sarah Smith Koberlein, RN, BSN, PMHNP-BC
• Polina Kopylova, LMSW, LADAC II
• Linda Marie Lindsay, PHARM.D.
• Justine Link
• Timothy Isaac Miller Locastro, B.A., CNA
• Eric Allen Long
• Christina Day Mahan, PMHNP

• Psychiatry Physician in Louisville, TN
• Providers in Louisville, TN by specialty
• Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.