Concord Recovery Center

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

Legal business name

CONCORD RECOVERY CENTER

Doing business as

Concord Recovery Center LLC

Practice address

601 S Concord St Ste 108
Knoxville, TN 37919-3339

Phone

(865) 985-0371

Fax

(865) 985-0649

NPI assigned

Dec 12, 2019

Last updated

May 25, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Crissy L Shank

Title

Billing

Phone

(931) 761-5732

Specialties & licenses 3

Addresses

Other names 1

• Concord Recovery Center LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Debbie Ann Bolton, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Greeneville, TN
  • NPI 1689893810
  Medicare reassignment NPD
• Guy Clark, MD

  • Internal Medicine Physician
  • Knoxville, TN
  • NPI 1235160789
  Medicare reassignment NPD
• Gabriel Reed Archer, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Salem, VA
  • NPI 1245950153

  TN

  Medicare reassignment

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1386282036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S CONCORD ST STE 108",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379193339",
            "telephone_number": "865-985-0371",
            "fax_number": "865-985-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S CONCORD ST STE 108",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379193339",
            "telephone_number": "865-985-0371",
            "fax_number": "865-985-0649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORD RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-12",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "SHANK",
        "authorized_official_first_name": "CRISSY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "931-761-5732"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concord Recovery Center LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Nicole Conard, MS
• Shannon D Conatser, CRNA
• Samuel Lee Conaway, PA-C
• Concord Adult Day Enrichment Services
• Concord Child and Family Psychology, PLLC
• Alejandro Conde
• Lauren Mitzi Conde, FNP-C
• Raquael Luvonne Condra
• John Michael Condry, O.D.
• Amber Metz Conger

• Addiction Medicine (Internal Medicine) Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Addiction Medicine (Internal Medicine) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.