Individual provider Active NPI

Savannah S Tallent, FNP-C

  • Family Nurse Practitioner
  • Maryville, TN
National Provider Identifier
1568080836
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
30252 Issued in TN
Practice address
3011 Dominion Dr
Maryville, TN 37803-8309
Phone
(865) 247-3772
NPI assigned
Jul 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 30252 TN Primary
Registered Nurse 163W00000X 234948 TN

Addresses

Primary practice location

3011 Dominion Dr
Maryville, TN 37803-8309

Mailing address

3011 Dominion Drive
Maryville, TN 37803-2261
Phone (865) 247-3772

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230928000117 TN Practitioner - Nurse Practitioner 4880048693 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
234948TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Sanders Obstetrical and Gynecological Group, P.C. CurrentSince Aug 15, 2023 Accepting new patients
Fort Sanders Obstetrical and Gynecological Group II LLC Past Accepting new patients

Locations

9314 Park West Blvd
Ste 303
Knoxville, TN 37923
Phone (865) 524-3208

501 19th St
Ste 509
Knoxville, TN 37916
Phone (423) 524-1024

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1568080836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 DOMINION DRIVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378032261",
            "telephone_number": "865-247-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 DOMINION DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378038309",
            "telephone_number": "865-247-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLENT",
        "first_name": "SAVANNAH",
        "middle_name": "S",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "30252",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "234948",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.