Individual provider Active NPI

Lorie L Bateman, PA-C

  • Physician Assistant
  • Knoxville, TN
National Provider Identifier
1982734117
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
004305 Issued in GA
Practice address
259 N Peters Rd Ste 103
Knoxville, TN 37923-4923
Phone
(865) 690-1255
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2679 TN
Physician Assistant 363A00000X 004305 GA Primary

Addresses

Primary practice location

259 N Peters Rd Ste 103
Knoxville, TN 37923-4923

Mailing address

8033 Ray Mears Blvd
Knoxville, TN 37919
Phone (865) 670-2383

Other practice location 1

444 W Fort St. Fl 2
Boise, ID 83702-4535
Phone (208) 422-1018

Other identifiers 2

IdentifierTypeStateIssuer
051787607BMedicaidGA
051787607AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221205000746 UT Order and Referring Only - Physician Assistant 0547364184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2679TNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Sr Medical Services Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1982734117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8033 RAY MEARS BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37919",
            "telephone_number": "865-670-2383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 N PETERS RD STE 103",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234923",
            "telephone_number": "865-690-1255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 W Fort St. Fl 2",
            "address_purpose": "LOCATION",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024535",
            "country_code": "US",
            "telephone_number": "208-422-1018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BATEMAN",
        "first_name": "LORIE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "2679",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051787607B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051787607A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.