Ensemble Medical PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ENSEMBLE MEDICAL PLLC

Practice address

417 Holly St
Knoxville, TN 37917-7815

Phone

(865) 633-9068

Fax

(865) 246-2106

NPI assigned

Apr 25, 2017

Organization subpart

No

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

Authorized official

Name

Deaver T Shattuck, M.D.

Title

President

Phone

(865) 633-9068

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497916800000",
    "number": "1821523101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5777",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378025777",
            "telephone_number": "865-246-2104",
            "fax_number": "865-246-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 HOLLY ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379177815",
            "telephone_number": "865-633-9068",
            "fax_number": "865-246-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENSEMBLE MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-25",
        "last_updated": "2017-06-20",
        "status": "A",
        "authorized_official_last_name": "SHATTUCK",
        "authorized_official_first_name": "DEAVER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-633-9068",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph English, BA
• Eric S. Engum, PH.D., J.D.
• Rachel E. Enigk, P.A.
• Regina Ruth Enneking, B.A.
• Laura M Enomoto, MD
• Ensemble Recovery Enterprises, LLC
• Ensight Health and Fitness Consulting
• Laurel Elena Ensign-Simmons
• Envirolab PC
• Charlie Gordon Epley Jr., D.PH.

• Internal Medicine Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2017; 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.