Individual provider Active NPI

Timothy Scott Rocklein, PA-C

  • Medical Physician Assistant
  • Knoxville, TN
National Provider Identifier
1538407846
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9107054 Issued in FL
Practice address
11416 Grigsby Chapel Rd Ste 104
Knoxville, TN 37934-1649
Phone
(865) 218-2100
Fax
(865) 218-2101
NPI assigned
Jan 21, 2013
Last updated
Jan 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9107054 FL Primary
Surgical Physician Assistant 363AS0400X PA 9107054 FL

Addresses

Primary practice location

11416 Grigsby Chapel Rd Ste 104
Knoxville, TN 37934-1649

Mailing address

PO Box 2070
Cleveland, TN 37320-2070
Phone (423) 339-9581

Other practice location 1

101 Donner Dr
Oak Ridge, TN 37830-7745
Phone (865) 685-0941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130227000415 FL Practitioner - Physician Assistant 7315192176 Reassigns benefits to 1 organization
I20230130000536 TN Practitioner - Physician Assistant 7315192176 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 9107054FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Pain Consultants CurrentSince Jan 30, 2023 Accepting new patients
Elite Pain Consultants, PLLC CurrentSince Jan 30, 2023 Accepting new patients
Interventional Pain Consultants CurrentSince Jan 30, 2023 Accepting new patients

Locations

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

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

101 Donner Dr
Oak Ridge, TN 37830
Phone (865) 685-0941

Interoperability endpoints

  • Direct secure messaging: timothy.rocklein.p2@direct.painreliefcenters.nextgenshare.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1358726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1538407846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2070",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373202070",
            "telephone_number": "423-339-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11416 GRIGSBY CHAPEL RD STE 104",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379341649",
            "telephone_number": "865-218-2100",
            "fax_number": "865-218-2101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Donner Dr",
            "address_purpose": "LOCATION",
            "city": "Oak Ridge",
            "state": "TN",
            "postal_code": "378307745",
            "country_code": "US",
            "telephone_number": "865-685-0941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCKLEIN",
        "first_name": "TIMOTHY",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-21",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9107054",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA 9107054",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.