Provider Demographics
NPI:1235977158
Name:NEWMAN, JASON CHAD (ATC)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:CHAD
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 CAMBRIDGE CREST LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-2029
Mailing Address - Country:US
Mailing Address - Phone:865-719-0472
Mailing Address - Fax:
Practice Address - Street 1:1600 PHILLIP FULMER AVE RM 206
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37996-4511
Practice Address - Country:US
Practice Address - Phone:865-719-0472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN03762255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty