Physician Associate Resources, PLC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Legal business name

PHYSICIAN ASSOCIATE RESOURCES, PLC

Doing business as

Clinica Familiar Latinoamerica

Practice address

1559 Highland Park Drive
Lenoir City, TN 37772

Phone

(865) 748-5057

Fax

(865) 635-8390

NPI assigned

Mar 26, 2019

Last updated

Dec 20, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rudy Gary Hamm, PA-CNPI 1649270844

Title

Provider

Phone

(865) 635-8389

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Clinica Familiar Latinoamerica Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

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.

• Rudy Gary Hamm, PA-C

  • Medical Physician Assistant
  • Lenoir City, TN
  • NPI 1649270844
  Medicare reassignment Authorized official
• Mary Jo Stone Biss, APN

  • Nurse Practitioner
  • Knoxville, TN
  • NPI 1386934396
  NPD
• Timothy Thomason, PA-C

  • Physician Assistant
  • Pigeon Forge, TN
  • NPI 1972665370

  Medical

  NPD (past)

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576800000000",
    "number": "1811458565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1559 HIGHLAND PARK DR",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377726237",
            "telephone_number": "865-635-8389",
            "fax_number": "865-635-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1559 HIGHLAND PARK DRIVE",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "37772",
            "telephone_number": "865-748-5057",
            "fax_number": "865-635-8390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1559 Highland Park Dr",
            "address_purpose": "LOCATION",
            "city": "Lenoir City",
            "state": "TN",
            "postal_code": "377726237",
            "country_code": "US",
            "telephone_number": "865-635-8389",
            "fax_number": "865-635-8390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSICIAN ASSOCIATE RESOURCES, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A",
        "authorized_official_last_name": "HAMM",
        "authorized_official_first_name": "RUDY",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "865-635-8389",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TN",
            "identifier": "PA0000000203",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3669684",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica Familiar Latinoamerica",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Cynthia Mae Petty, CPHT
• Karen Jane Phillips-Wilson, CRNA
• Physicians Clinic, P.C.
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• Physiotherapy Associates Inc (Select Physical Therapy)
• Kathryn Pierce, APN
• Kelly J Piper, PA-C

• Medical Physician Assistant in Lenoir City, TN
• Providers in Lenoir City, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; 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.