Breanna Alison Beck, PA-C
Individual provider Active NPI Physician Assistant · Maryville, TN
NPI 1699093286 · NPPES record last updated Aug 23, 2023
Key facts
- NPI
- 1699093286
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA2302 (TN)
- Practice address
- 907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015 - Phone
- (865) 980-4897
- Fax
- (865) 977-4796
- NPI assigned
- May 7, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southeastern Physician Services PC
Practice addresses (Care Compare)
10820 Parkside Dr
Knoxville, TN 37934-1956
Phone (865) 218-7011
Hospital & facility affiliations
- Physicians Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130708000701 | TN | Practitioner - Physician Assistant | 0941440341 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002932 | OH | MD | Athletic Trainer |
| PA2302 | TN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blount Memorial Hospital, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 002932 | OH | |
| Physician Assistant | 363A00000X | PA2302 | TN | Yes |
Addresses
Primary practice location
907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015
Mailing address
PO Box 4068
Maryville, TN 37802-4068
Phone (865) 273-1752
Other practice location 1
1240 Tennova Medical Way
Knoxville, TN 37909-3120
Phone (865) 444-3770 ext. 1006
Other providers in Maryville, TN
- Laronda Collins Beam
- Bears Den Co
- Camisha Lachelle Beasley
- Samantha Beaudry
- Beauty From Ashes Coaching, Counseling, and Consultation, LLC
- Kathryn Becker
- Bobbie Wear Beckmann
- Joshua Beeler
- Brittney L. Bell
- William Kenneth Bell
All providers in Maryville, TN · Physician Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.