Ensemble Recovery Enterprises, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3550 Issued in TN

Legal business name

ENSEMBLE RECOVERY ENTERPRISES, LLC

Practice address

417 Holly St
Knoxville, TN 37917-7815

Phone

(865) 770-4003

Fax

(865) 246-2106

NPI assigned

Sep 29, 2017

Organization subpart

No

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

Authorized official

Name

Deaver T Shattuck, MD

Title

Chief Medical Officer

Phone

(865) 770-3838

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506643200000",
    "number": "1346759636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5777",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378025777",
            "telephone_number": "865-246-2104",
            "fax_number": "865-246-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 HOLLY ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379177815",
            "telephone_number": "865-770-4003",
            "fax_number": "865-246-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENSEMBLE RECOVERY ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-29",
        "last_updated": "2017-09-29",
        "status": "A",
        "authorized_official_last_name": "SHATTUCK",
        "authorized_official_first_name": "DEAVER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "865-770-3838",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "3550",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "27892",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21354",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric S. Engum, PH.D., J.D.
• Rachel E. Enigk, P.A.
• Regina Ruth Enneking, B.A.
• Laura M Enomoto, MD
• Ensemble Medical PLLC
• Ensight Health and Fitness Consulting
• Laurel Elena Ensign-Simmons
• Envirolab PC
• Charlie Gordon Epley Jr., D.PH.
• Ashley Epperly, NP

• Clinical Social Worker in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2017; 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.