Individual provider Active NPI

Christine Pellenz

  • Clinical Social Worker
  • Oak Ridge, TN
National Provider Identifier
1609426964
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
240 W Tyrone Rd
Oak Ridge, TN 37830-6571
Phone
(865) 482-1076
NPI assigned
Sep 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

240 W Tyrone Rd
Oak Ridge, TN 37830-6571

Mailing address

240 W Tyrone Rd
Oak Ridge, TN 37830-6571
Phone (865) 482-1076

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191215000059 TN Practitioner - Clinical Social Worker 5890128367 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7110TNMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgeview Psychiatric Hospital and Center, Inc. CurrentSince Aug 28, 2019 Accepting new patients
Mental Health Centers & Clinics of Tennessee PastSince Aug 28, 2019 Accepting new patients

Locations

110 N Tennessee Ave
La Follette, TN 37766
Phone (423) 562-7426

240 W Tyrone Rd
Oak Ridge, TN 37830
Phone (865) 482-1076

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": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1609426964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W TYRONE RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306571",
            "telephone_number": "865-482-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W TYRONE RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306571",
            "telephone_number": "865-482-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLENZ",
        "first_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-18",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.