NPIMap

Organization Active NPI

White Spirit Lodge Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Knoxville, TN
National Provider Identifier
1457515371
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
605 Issued in TN
Legal business name
WHITE SPIRIT LODGE INC.
Practice address
146 Maryville Pike
Sutie 101
Knoxville, TN 37920-4185
Phone
(865) 577-0530
Fax
(865) 577-0430
NPI assigned
Jul 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Mark Michael McCarter
Title
Manager
Phone
(865) 577-0530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 605 TN Primary

Addresses

Primary practice location

146 Maryville Pike
Sutie 101
Knoxville, TN 37920-4185

Mailing address

146 Maryville Pike
Sutie 101
Knoxville, TN 37920-4185
Phone (865) 577-0530

National Provider Directory

National Provider Directory

Locations

146 Maryville Pike
Ste 101
Knoxville, TN 37920
Phone (865) 577-0530

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1457515371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 MARYVILLE PIKE",
            "address_2": "SUTIE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379204185",
            "telephone_number": "865-577-0530",
            "fax_number": "865-577-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 MARYVILLE PIKE",
            "address_2": "SUTIE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379204185",
            "telephone_number": "865-577-0530",
            "fax_number": "865-577-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE SPIRIT LODGE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "MCCARTER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "865-577-0530"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TN",
            "license": "605",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 10, 2008; 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.