Allergy & Asthma Affiliates, PC
Organization Active NPI Allergy & Immunology Physician · Knoxville, TN
NPI 1780809012 · NPPES record last updated Mar 28, 2008
Key facts
- NPI
- 1780809012
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Allergy & Immunology Physician 207K00000X
- Legal business name
- ALLERGY & ASTHMA AFFILIATES, PC
- Practice address
- 2121 Highland Ave
Knoxville, TN 37916-1111 - Phone
- (865) 525-2640
- Fax
- (865) 252-9536
- NPI assigned
- Apr 13, 2007
- Organization subpart
- No
Authorized official
- Name
- Louis Mavroff
- Title
- Practice Manager
- Phone
- (865) 525-2640
Other NPIs on the same Medicare enrollment 8
Corporate family (same tax ID) 8
Practitioners 10
-
Olivia Caroline Art, FNP
-
Christin R Carter, FNP
-
Donald T. Ellenburg, M.D.
-
Joseph Trent Ellenburg, D.O.
-
Jennifer Lynne Hall, FNP
-
Kristin Renae Hickman, APRN
-
Kristine Marie Meade, FNP-BC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0972108 | Allergy and Asthma Affiliates | Provider-performed microscopy | Mar 28, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040819001511 | TN | Part B Supplier - Clinic/Group Practice | 7012981772 |
Receives reassigned benefits from 10 practitioners 8 other NPIs on this enrollment Practice locations: Alcoa, TN; Sevierville, TN; Powell, TN; Oak Ridge, TN; Morristown, TN; Knoxville, TN; Farragut, TN |
National Provider Directory
- Tax ID family
- Regional Children'S
Locations
808 W 4th North St
Morristown, TN 37814
Phone (423) 254-3590
7714 Conner Rd
Ste 108
Powell, TN 37849
Phone (865) 938-7759
632 Dolly Parton Pkwy
Ste 5
Sevierville, TN 37862
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician |
207K00000X | Yes |
Addresses
Primary practice location
2121 Highland Ave
Knoxville, TN 37916-1111
Mailing address
2121 Highland Ave
Knoxville, TN 37916-1111
Phone (865) 525-2640
NPI Registry JSON
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1206662400000",
"number": "1780809012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2121 HIGHLAND AVE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379161111",
"telephone_number": "865-525-2640",
"fax_number": "865-252-9536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 HIGHLAND AVE",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379161111",
"telephone_number": "865-525-2640",
"fax_number": "865-252-9536"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALLERGY & ASTHMA AFFILIATES, PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-13",
"last_updated": "2008-03-28",
"status": "A",
"authorized_official_last_name": "MAVROFF",
"authorized_official_first_name": "LOUIS",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "865-525-2640"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Allergy & Immunology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
- Todd Carl Allen
- Tyler Reed Allen
- Vickie R Allen
- Wesley Allen
- Allergic Diseases Asthma & Immunology Clinic PC
- Allergy & Asthma Affiliates, PC
- Allergy & Asthma Affiliates, PC
- Allergy Associates PA
- Allergy Associates PA
- Allergy Associates PA
All providers in Knoxville, TN · Allergy & Immunology Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2008. 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.
- 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.