Individual provider Active NPI

Carrie Patricia Freire-Bozeman, NP

  • Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1659669497
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
15945 Issued in TN
Practice address
1128 E Weisgarber Rd Ste 100
Knoxville, TN 37909-2677
Phone
(865) 579-0552
Fax
(865) 934-2680
NPI assigned
Jul 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 15945 TN Primary

Addresses

Primary practice location

1128 E Weisgarber Rd Ste 100
Knoxville, TN 37909-2677

Mailing address

1128 E Weisgarber Rd Ste 100
Knoxville, TN 37909-2677
Phone (865) 579-0552

Other identifiers 1

IdentifierTypeStateIssuer
1531066MedicaidTN

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
I20110809000716 TN Practitioner - Nurse Practitioner 9537338470 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Tennessee, HSC, College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pain Consultants of East Tennessee, PLLCGroup PAC ID 3173424298, 18 clinicians

Practice addresses (Care Compare)

575 Oak Ridge Tpke
Suite 110
Oak Ridge, TN 37830-7173
Phone (865) 579-0552

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
15945TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Medicine Institute PC CurrentSince Sep 23, 2012 Accepting new patients
Pain Consultants of East Tennessee, PLLC CurrentSince Jul 6, 2021 Accepting new patients
Stuart PC Past Accepting new patients

Locations

220 Fort Sanders West Blvd
Ste 308
Knoxville, TN 37922
Phone (865) 579-0552

1540 Member Ln
Ste 100
Knoxville, TN 37909
Phone (865) 579-0552

1128 E Weisgarber Rd
Ste 100
Knoxville, TN 37909
Phone (865) 251-5215

575 Oak Ridge Tpke
Ste 110
Oak Ridge, TN 37830
Phone (865) 579-0552

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1659669497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 E WEISGARBER RD STE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092677",
            "telephone_number": "865-579-0552",
            "fax_number": "865-541-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 E WEISGARBER RD STE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092677",
            "telephone_number": "865-579-0552",
            "fax_number": "865-934-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREIRE-BOZEMAN",
        "first_name": "CARRIE",
        "middle_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2021-07-26",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "15945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1531066",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.