Maryville Foot Clinic Inc

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

564 Issued in TN

Legal business name

MARYVILLE FOOT CLINIC INC

Practice address

1515 E Lamar Alexander Pkwy
Maryville, TN 37804-5131

Phone

(865) 982-2119

Fax

(865) 984-5642

NPI assigned

Jul 25, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Brandi C Hegerty

Title

Office Manager

Phone

(865) 681-6667

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amber Heather Tessmer-Neubauer, DPM

  • Foot Surgery Podiatrist
  • Murfreesboro, TN
  • NPI 1487762894
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1730101734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045131",
            "telephone_number": "865-982-2119",
            "fax_number": "865-984-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045131",
            "telephone_number": "865-982-2119",
            "fax_number": "865-984-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYVILLE FOOT CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "HEGERTY",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "865-681-6667",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "TN",
            "license": "564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN0101",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7404093",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3732878",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1231208",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4118088",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "BNA2743006",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maryville Anesthesiologists PC
• Maryville ASC
• Maryville Dental Care
• Maryville Dental, PLLC.
• Maryville Fairpark Opco LLC
• Maryville Jamestown Opco LLC
• Maryville Massage
• Maryville Surgical Center
• Gary Merlin Mason, M.D.
• Madison Mathenia, SLP

• Primary Podiatric Medicine Podiatrist in Maryville, TN
• Providers in Maryville, TN by specialty
• Primary Podiatric Medicine Podiatrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.