Active NPI
Korrie Xavier, LMSW
- Clinical Social Worker
- Maryville, TN
National Provider Identifier
1538744313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LSW0000013022
- Practice address
- 1700 Elm Dr
Maryville, TN 37804-4327 - Phone
- (865) 309-5427
- NPI assigned
- Mar 13, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LSW0000013022 | TN | Primary |
Addresses
Primary practice location
1700 Elm Dr
Maryville, TN 37804-4327
Mailing address
PO Box 5568
Maryville, TN 37802-5568
Phone (865) 351-0393
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LSW0000013022 | TN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychotherapy and Forensic Services | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630972800000",
"number": "1538744313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5568",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378025568",
"telephone_number": "865-351-0393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 ELM DR",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378044327",
"telephone_number": "865-309-5427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "XAVIER",
"first_name": "KORRIE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-13",
"last_updated": "2021-09-07",
"certification_date": "2021-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "LSW0000013022",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maryville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.