Individual provider Active NPI

Marjorie Carolanne Pickel, NP

  • Family Nurse Practitioner
  • Oak Ridge, TN
National Provider Identifier
1366531964
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7782 Issued in TN
Practice address
103 Donner Dr
Oak Ridge, TN 37830
Phone
(865) 685-0941
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 7782 TN
Family Nurse Practitioner 363LF0000X 7782 TN Primary

Addresses

Primary practice location

103 Donner Dr
Oak Ridge, TN 37830

Mailing address

102 Dunhill PL NW
Cleveland, TN 37311-3885
Phone (423) 472-0459

Other practice location 1

11416 Grigsby Chapel Rd Ste 104
Knoxville, TN 37934
Phone (865) 218-2100

Other practice location 2

102 Dunhill Pl NW
Cleveland, TN 37311-3885
Phone (423) 339-9581

Other identifiers 3

IdentifierTypeStateIssuer
100041600OtherTNPHP TENNCARE
1532620MedicaidTN
P00154886OtherTNTRAVELERS MEDICARE

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040819001231 TN Practitioner - Nurse Practitioner 5597739219 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7782TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Tennessee, P.C. CurrentSince Oct 1, 2004 Accepting new patients

Locations

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

501 20th St
Ste 606
Knoxville, TN 37916
Phone (865) 331-2278

900 E Hill Ave
Knoxville, TN 37915
Phone (865) 545-7817

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1366531964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 DUNHILL PL NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113885",
            "telephone_number": "423-472-0459",
            "fax_number": "423-472-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 DONNER DR",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "37830",
            "telephone_number": "865-685-0941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11416 Grigsby Chapel Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "37934",
            "country_code": "US",
            "telephone_number": "865-218-2100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 Dunhill Pl NW",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "TN",
            "postal_code": "373113885",
            "country_code": "US",
            "telephone_number": "423-339-9581",
            "fax_number": "423-472-0454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICKEL",
        "first_name": "MARJORIE",
        "middle_name": "CAROLANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "7782",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "7782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP TENNCARE",
            "identifier": "100041600",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1532620",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "P00154886",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.