Active NPI
Nutritional Support Services
- Parenteral & Enteral Nutrition Supplies (DME)
- Knoxville, TN
National Provider Identifier
1689601809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Parenteral & Enteral Nutrition Supplies (DME)
- Legal business name
- NUTRITIONAL SUPPORT SERVICES
- Practice address
- 9000 Executive Park Drive
Suite a 301
Knoxville, TN 37923-4656 - Phone
- (865) 690-9900
- Fax
- (865) 531-7016
- NPI assigned
- Jun 26, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Terry Leeman
- Title
- Executive Director
- Phone
- (865) 690-9900
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Nursing Facility Supplies (DME) | 332BN1400X | |||
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | Primary |
Addresses
Primary practice location
9000 Executive Park Drive
Suite a 301
Knoxville, TN 37923-4656
Mailing address
PO Box 32249
Knoxville, TN 37930-2249
Phone (865) 690-9900
Other identifiers 19
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112948716 | Medicaid | AR | |
| 30762373 | Medicaid | NH | |
| 3545979 | Medicaid | TN | |
| DM0001 | Medicaid | SC | |
| 622293603 | Medicaid | MO | |
| 00571986A | Medicaid | GA | |
| 209086400 | Medicaid | FL | |
| 100010580A | Medicaid | IN | |
| 10MF49 | Other | ALLIANCE BCBS | |
| 90262056 | Medicaid | KY | |
| 1354317 | Medicaid | LA | |
| 40111 | Medicaid | MS | |
| 073622502 | Medicaid | TX | |
| 100002960A | Medicaid | KS | |
| 9143513 | Medicaid | VA | |
| 009000730 | Medicaid | AL | |
| 01305375 | Medicaid | NY | |
| 7611272 | Medicaid | MN | |
| 80966900 | Medicaid | WI |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1580169600000",
"number": "1689601809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 32249",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379302249",
"telephone_number": "865-690-9900",
"fax_number": "865-531-7016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 EXECUTIVE PARK DRIVE",
"address_2": "SUITE A 301",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379234656",
"telephone_number": "865-690-9900",
"fax_number": "865-531-7016"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NUTRITIONAL SUPPORT SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-26",
"last_updated": "2020-01-28",
"certification_date": "2020-01-28",
"status": "A",
"authorized_official_last_name": "LEEMAN",
"authorized_official_first_name": "TERRY",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "865-690-9900"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "332BN1400X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "112948716",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30762373",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3545979",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DM0001",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "622293603",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00571986A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "209086400",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100010580A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALLIANCE BCBS",
"identifier": "10MF49",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "90262056",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1354317",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40111",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "073622502",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100002960A",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9143513",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009000730",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01305375",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7611272",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "80966900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.