Provider Demographics
NPI:1871522052
Name:TENNESSEE ORTHOPAEDIC CLINICS PC
Entity type:Organization
Organization Name:TENNESSEE ORTHOPAEDIC CLINICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:ZENA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-694-0062
Mailing Address - Street 1:9129 CROSS PARK DR STE 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4505
Mailing Address - Country:US
Mailing Address - Phone:865-694-7725
Mailing Address - Fax:865-694-7907
Practice Address - Street 1:9129 CROSS PARK DR
Practice Address - Street 2:SUITE 101
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4505
Practice Address - Country:US
Practice Address - Phone:865-694-7725
Practice Address - Fax:865-694-7907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3376147Medicaid
TNQ049223Medicaid
TN3376148Medicaid
TNQ002830Medicaid
TN3376144Medicaid
TN3376146Medicaid
TN1525847Medicaid
TN3376140Medicaid
TN3376145Medicaid
TNQ019519Medicaid
TN3376140Medicaid
0677340005Medicare NSC
TN3719393Medicaid
TN1525847Medicaid
TN3376140Medicaid
0677340003Medicare NSC
3376147Medicare PIN
3376148Medicare PIN
TN3376148Medicaid
TN0677340010Medicare NSC
0677340008Medicare NSC
0677340004Medicare NSC
TN3376145Medicaid
0677340007Medicare NSC
3376146Medicare PIN
3376145Medicare PIN
3719393Medicare PIN
3716130Medicare PIN