MARYVILLE FOOT CLINIC INC NPI 1730101734

NPI Information

NPI: 1730101734
Provider Name: MARYVILLE FOOT CLINIC INC
Classification: Podiatrist - 213EP1101X
Entity Type: Organization

Specialization: Primary Podiatric Medicine

Address:
1515 E LAMAR ALEXANDER PKWY
MARYVILLE, TN
ZIP 37804
Phone: (865) 982-2119
Get Directions

MARYVILLE FOOT CLINIC INC is a primary podiatric medicine podiatrist in Maryville, TN. MARYVILLE FOOT CLINIC INC NPI is 1730101734. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1515 E LAMAR ALEXANDER PKWY
MARYVILLE, TN
ZIP 37804-131
Phone: (865) 982-2119
Fax: (865) 984-5642

The provider's authorized official is Brandi C Hegerty .
The authorized official title is Office Manager and has the following contact phone number (865) 681-6667.

The enumeration date for this NPI number is 7/25/2006 and was last updated on 4/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213EP1101X	Podiatrist	Primary Podiatric Medicine	564	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========	OTHER	TENNESSEE	HEALTH COST SOLUTIONS
2	=========	OTHER	TENNESSEE	FISERV HEALTH
3	5629140001	MEDICARE NSC	TENNESSEE
4	7404093	OTHER	TENNESSEE	AETNA
5	=========	OTHER	TENNESSEE	CARITEN
6	1231208	OTHER	TENNESSEE	CIGNA
7	3732878	MEDICARE ID-TYPE UNSPECIFIED	TENNESSEE	GROUP NUMBER
8	=========	OTHER	TENNESSEE	TRICARE SOUTH
9	TN0101	OTHER	TENNESSEE	JOHN DEERE
10	=========	OTHER	TENNESSEE	HUMANA
11	4118088	OTHER	TENNESSEE	BCBS OF TN
12	3732878	MEDICAID	TENNESSEE
13	BNA2743006	OTHER	TENNESSEE	UNITED HEALTHCARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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