East Tenn Neurology CL PC

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

License

MD17875 Issued in TN

Legal business name

EAST TENN NEUROLOGY CL PC

Practice address

140 Market Place Blvd BLDG E
Knoxville, TN 37922-2337

Phone

(865) 531-9430

Fax

(865) 531-9580

NPI assigned

Jul 16, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Samir Al-Kabbani, MDNPI 1083681183

Title

President

Phone

(865) 531-9430

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 6

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

• Samir Al-Kabbani, MD

  • Neurology Physician
  • Knoxville, TN
  • NPI 1083681183
  Medicare reassignment Authorized official
• Mina Farrar, NP

  • Family Nurse Practitioner
  • Knoxville, TN
  • NPI 1275930380
  Medicare reassignment NPD
• Jairo Alfredo Fortich, M.D.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1104867381
  NPD (past)
• Susan T. Hicks, FNP

  • Family Nurse Practitioner
  • Knoxville, TN
  • NPI 1477938660
  NPD (past)
• David A Neal, LCSW

  • Clinical Social Worker
  • Knoxville, TN
  • NPI 1578612156
  NPD (past)
• Cynthia Payne-Smith, NP

  • Nurse Practitioner
  • Knoxville, TN
  • NPI 1053400788
  NPD (past)

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787184000000",
    "number": "1932308293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 MARKET PLACE BLVD BLDG E",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379222337",
            "telephone_number": "865-531-9430",
            "fax_number": "865-531-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 MARKET PLACE BLVD BLDG E",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379222337",
            "telephone_number": "865-531-9430",
            "fax_number": "865-531-9580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TENN NEUROLOGY CL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A",
        "authorized_official_last_name": "AL-KABBANI",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-531-9430",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "TN",
            "license": "MD17875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3386763",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Elizabeth Earnest, CPNP
• Joseph L. Easley III, DPT
• Martin Phan Eason, MD
• Taijae Eason
• East Able Tennessee, LLC
• East Tennesse Urology Specialists
• East Tennessee Allergy PC
• East Tennessee Cardiovascular Surgery Group, P.C
• East Tennessee Children'S Hospital Association Inc.
• East Tennessee Children'S Hospital Association Inc.

• Addiction Medicine (Psychiatry & Neurology) Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; 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.