Active NPI
Eldora L Fitzsimmons, L.C.S.W.
- Clinical Social Worker
- Knoxville, TN
National Provider Identifier
1699757013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 00003384
- Practice address
- 1031 Eleanor St
Knoxville, TN 37917-6641 - Phone
- (865) 607-1031
- Fax
- (865) 523-4818
- NPI assigned
- Nov 20, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 00003384 | TN | Primary |
Addresses
Primary practice location
1031 Eleanor St
Knoxville, TN 37917-6641
Mailing address
PO Box 27183
Knoxville, TN 37927-7183
Phone (865) 523-4818
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 249179 | Other | TN | COMPSYCH |
| 003034281 | Other | TN | BLUECROSSBLUESHEILD TN |
| 138M5 | Other | NC | BCBS OF NC |
| 154785 | Other | NC | VALUE OPTIONS |
| 95920 | Other | NC | UNITED BEHAVIORAL HEALTH |
| 95920 | Other | TN | UNITED BEHAVIORAL HEALTH |
| 245841 | Other | NC | MHN |
| 245841 | Other | TN | MHN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00003384 | TN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578960000000",
"number": "1699757013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27183",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379277183",
"telephone_number": "865-523-4818",
"fax_number": "865-774-4235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1031 ELEANOR ST",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379176641",
"telephone_number": "865-607-1031",
"fax_number": "865-523-4818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZSIMMONS",
"first_name": "ELDORA",
"middle_name": "L",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-20",
"last_updated": "2020-01-14",
"certification_date": "2020-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "00003384",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPSYCH",
"identifier": "249179",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSSBLUESHEILD TN",
"identifier": "003034281",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NC",
"identifier": "138M5",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "154785",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "95920",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "95920",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN",
"identifier": "245841",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN",
"identifier": "245841",
"state": "TN"
}
],
"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 14, 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.