| Chestnut Health Of Tennessee Pllc | |
|
2830 Highway 394 Blountville TN 37617-5577 | |
| (423) 274-6191 | |
| (703) 649-6188 |
| Full Name | Chestnut Health Of Tennessee Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2830 Highway 394, Blountville, Tennessee |
| Authorized Official Name and Position | Omair Siraj (OWNER) |
| Authorized Official Contact | 7039648199 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chestnut Health Of Tennessee Pllc Po Box 904 Bedford Park IL 60499-0904 Ph: (703) 964-8199 | Chestnut Health Of Tennessee Pllc 2830 Highway 394 Blountville TN 37617-5577 Ph: (423) 274-6191 |
| NPI Number | 1730928706 |
|---|---|
| Provider Enumeration Date | 05/21/2024 |
| Last Update Date | 06/18/2024 |
| Medicare PECOS PAC ID | 8123567633 |
|---|---|
| Medicare Enrollment ID | O20240828003578 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730928706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Wendy Swiney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669708848 PECOS PAC ID: 5597809749 Enrollment ID: I20100225000668 |
| Provider Name | Allison M Susman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629585559 PECOS PAC ID: 3577819366 Enrollment ID: I20180710000545 |
| Provider Name | Rebecca Friedman Novick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114331097 PECOS PAC ID: 2163640020 Enrollment ID: I20230113001620 |
| Provider Name | Casey Mae Bates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720709744 PECOS PAC ID: 1254702897 Enrollment ID: I20230119000509 |
| Provider Name | Kuljit Kapur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831399518 PECOS PAC ID: 2860649985 Enrollment ID: I20240904000740 |
| Provider Name | Megan Mcmahon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902627532 PECOS PAC ID: 3971039918 Enrollment ID: I20241213000692 |
Medexpress Urgent Care, Pc - Virginia Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 140 Barefoot Landing Dr, Blountville, TN 37617 Phone: 304-225-2500 |