Active NPI
Lauren Rene Panezich, M.D.
- Family Medicine Physician
- Clinton, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 59405
- Practice address
- 102 S Charles G Seivers Blvd
Clinton, TN 37716-3916 - Phone
- (865) 457-4702
- Fax
- (865) 374-2115
- NPI assigned
- Nov 18, 2016
- Last updated
- Jan 10, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD.36850 | AL | |
| Family Medicine Physician | 207Q00000X | L.4372R | AL | |
| Family Medicine Physician | 207Q00000X | 59405 | TN | Primary |
Addresses
Primary practice location
102 S Charles G Seivers Blvd
Clinton, TN 37716-3916
Mailing address
102 S Charles G Seivers Blvd
Clinton, TN 37716-3916
Phone (865) 457-4702
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q049891 | Medicaid | TN |
Other names 1
- Dr. Lauren Rene Smith
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Smith.Lauren@covenanthealth.cernerdirect.com |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Alabama School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
110 Industrial Park LN
Lake City, TN 37769-2300
Phone (865) 426-7441
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L.4372R | AL | MD | Family Medicine Physician |
| MD.36850 | AL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Covenant Medical Group, Inc | Current | Accepting new patients |
Locations
102 S Seivers Blvd
Clinton, TN 37716
Phone (865) 457-4702
Dept 888179
Knoxville, TN 37995
111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554
110 Industrial Park Ln
Rocky Top, TN 37769
Phone (865) 426-7421
Interoperability endpoints
- smith.lauren@covenanthealth.cernerdirect.com
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Knoxville, TN
- NPI 1457302010
-
- Durable Medical Equipment & Medical Supplies
- Knoxville, TN
- NPI 1871269415
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Oak Ridge, TN
- NPI 1700870672
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1396288650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 S CHARLES G SEIVERS BLVD",
"city": "CLINTON",
"state": "TN",
"postal_code": "377163916",
"telephone_number": "865-457-4702",
"fax_number": "865-374-2115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 S CHARLES G SEIVERS BLVD",
"city": "CLINTON",
"state": "TN",
"postal_code": "377163916",
"telephone_number": "865-457-4702",
"fax_number": "865-374-2115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANEZICH",
"first_name": "LAUREN",
"middle_name": "RENE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-18",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AL",
"license": "MD.36850",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AL",
"license": "L.4372R",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "59405",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q049891",
"state": "TN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Smith.Lauren@covenanthealth.cernerdirect.com",
"affiliation": "N",
"address_1": "110 Executive Park Dr",
"city": "Clinton",
"state": "TN",
"country_code": "US",
"postal_code": "37716",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "LAUREN",
"last_name": "SMITH",
"middle_name": "RENE",
"prefix": "DR.",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Clinton, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.