Southeast Spine & Pain Associates LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

SOUTHEAST SPINE & PAIN ASSOCIATES LLC

Practice address

1718 Saint Mary St
Knoxville, TN 37917-4517

Phone

(865) 633-9469

Fax

(865) 633-9474

NPI assigned

Oct 15, 2012

Organization subpart

No

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

Authorized official

Name

Christie Lord

Title

Credentialing/Billing Manager

Phone

(865) 633-9469

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charlie M. Bartlett, F.N.P.

  • Nurse Practitioner
  • Knoxville, TN
  • NPI 1821022716
  Medicare reassignment Care Compare group NPD
• Sandra Elizabeth Charnley, APRN, FNP-BC

  • Family Nurse Practitioner
  • Knoxville, TN
  • NPI 1528570983
  Medicare reassignment Care Compare group NPD
• Joseph Dichiara, DO

  • Pain Medicine (Anesthesiology) Physician
  • Morristown, TN
  • NPI 1104118835
  Medicare reassignment Care Compare group NPD
• Jane E Gertz, CRNP

  • Family Nurse Practitioner
  • Knoxville, TN
  • NPI 1962474825
  Medicare reassignment Care Compare group NPD
• Kimberly Kay Lowe, FNP

  • Family Nurse Practitioner
  • Knoxville, TN
  • NPI 1093006751
  Medicare reassignment Care Compare group NPD
• Erika Nichols, NP

  • Family Nurse Practitioner
  • Orlando, FL
  • NPI 1922698273

  TN

  Medicare reassignment NPD

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426118400000",
    "number": "1649523689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27629",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379277629",
            "telephone_number": "865-633-9469",
            "fax_number": "865-633-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 SAINT MARY ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379174517",
            "telephone_number": "865-633-9469",
            "fax_number": "865-633-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST SPINE & PAIN ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-15",
        "last_updated": "2015-03-12",
        "status": "A",
        "authorized_official_last_name": "LORD",
        "authorized_official_first_name": "CHRISTIE",
        "authorized_official_title_or_position": "CREDENTIALING/BILLING MANAGER",
        "authorized_official_telephone_number": "865-633-9469"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1531106",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeast Behavioral Services
• Southeast Eye Surgery Center, LLC
• Southeast Oral Surgery PC
• Southeast Oral Surgery PC
• Southeast Precision Clinic of Chiropractic, PLLC
• Southeast Spine and Pain Associates Inc.
• Southeast Spine and Rehab Corp.
• Southeast Tennessee Health Clinic, LLC
• Southeastern Center for Fertility and Reproductive Surgery, PLLC
• Southeastern Dermatology Consultants, PC

• Pain Clinic/Center in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Pain Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.