NPIMap

Organization Active NPI

Innovative Primary Care, LLC

  • Medical Physician Assistant
  • Knoxville, TN
National Provider Identifier
1366993263
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Legal business name
INNOVATIVE PRIMARY CARE, LLC
Practice address
7035 Middlebrook Pike Ste B
Knoxville, TN 37909-1387
Phone
(865) 200-8672
Fax
(865) 544-1570
NPI assigned
Oct 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Authorized official

Name
Stacy Louise PinsonNPI 1346637725
Title
Office Administrator
Phone
(865) 200-8672

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X Primary

Addresses

Primary practice location

7035 Middlebrook Pike Ste B
Knoxville, TN 37909-1387

Mailing address

7035 Middlebrook Pike Ste B
Knoxville, TN 37909-1387
Phone (865) 200-8672

Other practice location 1

4320 Ball Camp Pike
Knoxville, TN 37921-3312
Phone (865) 544-1550

Other identifiers 1

IdentifierTypeStateIssuer
Q003416MedicaidTN

National Provider Directory

National Provider Directory

Locations

7305 Middlebrook Pike
Ste B
Knoxville, TN 37909

7035 Middlebrook Pike
Ste B
Knoxville, TN 37909
Phone (865) 200-8672

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574812800000",
    "number": "1366993263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7035 MIDDLEBROOK PIKE STE B",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091387",
            "telephone_number": "865-200-8672",
            "fax_number": "865-544-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7035 MIDDLEBROOK PIKE STE B",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091387",
            "telephone_number": "865-200-8672",
            "fax_number": "865-544-1570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4320 Ball Camp Pike",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379213312",
            "country_code": "US",
            "telephone_number": "865-544-1550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INNOVATIVE PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2019-11-27",
        "status": "A",
        "authorized_official_last_name": "PINSON",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "865-200-8672"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q003416",
            "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 27, 2019; 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.