University Health System, Inc

Organization Active NPI Internal Medicine Physician · Lenoir, TN

NPI 1922039429 · NPPES record last updated Jun 5, 2020

Key facts

NPI
1922039429
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
UNIVERSITY HEALTH SYSTEM, INC
Practice address
5779 Creekwood Park Blvd
Suite 220
Lenoir, TN 37772
Phone
(865) 670-6750
Fax
(865) 988-8772
NPI assigned
Jul 5, 2006
Organization subpart
No

Authorized official

Name
Beth A Maynard
Title
Vice President
Phone
(865) 670-6754

Practitioners 12

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031111000809 TN Part B Supplier - Clinic/Group Practice 5294646378 Receives reassigned benefits from 881 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Locations

1928 Alcoa Hwy
Ste B100
Knoxville, TN 37920
Phone (865) 305-6570

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207R00000X Yes

Addresses

Primary practice location

5779 Creekwood Park Blvd
Suite 220
Lenoir, TN 37772

Mailing address

PO Box 415000-Msc8137
Nashville, TN 37241-8137
Phone (865) 670-6199

Other identifiers

IdentifierTypeStateIssuer
32851413MedicaidTN

Other names

  • UT Primary Care Lenoir City Doing business as

Sources for this page

Verify at the official NPI Registry.