Organization Active NPI

Genesis Neuroscience Clinic LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Knoxville, TN
National Provider Identifier
1700497302
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
GENESIS NEUROSCIENCE CLINIC LLC
Practice address
1400 Dowell Springs Blvd Ste 340
Knoxville, TN 37909-2445
Phone
(865) 584-7376
Fax
(865) 444-7672
NPI assigned
Aug 17, 2020
Last updated
Jun 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Authorized official

Name
Dr. Monica K. Crane, MDNPI 1982713053
Title
Director
Phone
(865) 888-9494

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X NU Primary

Addresses

Primary practice location

1400 Dowell Springs Blvd Ste 340
Knoxville, TN 37909-2445

Mailing address

PO Box 10367
Knoxville, TN 37939-0367
Phone (865) 584-7376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210112001109 TN Part B Supplier - Clinic/Group Practice 6305259367 Receives reassigned benefits from 3 practitioners
Practice locations: Knoxville, TN

National Provider Directory

National Provider Directory

Locations

1400 Dowell Springs Blvd
Ste 340
Knoxville, TN 37909
Phone (865) 588-1605

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750032000000",
    "number": "1700497302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10367",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379390367",
            "telephone_number": "865-584-7376",
            "fax_number": "865-540-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 DOWELL SPRINGS BLVD STE 340",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092445",
            "telephone_number": "865-584-7376",
            "fax_number": "865-444-7672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS NEUROSCIENCE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-17",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A",
        "authorized_official_last_name": "CRANE",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "865-888-9494",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 16, 2025; 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.