| Family Medicine West Pllc | |
|
220 Fort Sanders West Blvd Bldg 2, Suite 200 Knoxville TN 37922 | |
| (865) 288-4232 | |
| (865) 288-4231 |
| Full Name | Family Medicine West Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 220 Fort Sanders West Blvd, Knoxville, Tennessee |
| Authorized Official Name and Position | Manisha S Thakur (OWNER) |
| Authorized Official Contact | 8652884232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine West Pllc 220 Fort Sanders West Blvd Bldg 2, Suite 200 Knoxville TN 37922 Ph: (865) 288-4232 | Family Medicine West Pllc 220 Fort Sanders West Blvd Bldg 2, Suite 200 Knoxville TN 37922 Ph: (865) 288-4232 |
| NPI Number | 1083962815 |
|---|---|
| Provider Enumeration Date | 08/28/2012 |
| Last Update Date | 09/17/2012 |
| Medicare PECOS PAC ID | 7618126608 |
|---|---|
| Medicare Enrollment ID | O20121008000403 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083962815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD30337 (Tennessee) | Primary |
| Provider Name | Manisha S Thakur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639152275 PECOS PAC ID: 7214841014 Enrollment ID: I20031117000256 |
| Provider Name | Katherine A Schoeller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588752505 PECOS PAC ID: 6204800683 Enrollment ID: I20040823000222 |
| Provider Name | Kevin E Stasney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437199205 PECOS PAC ID: 9739087255 Enrollment ID: I20050330001257 |
| Provider Name | Jennifer R Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821261884 PECOS PAC ID: 4284704156 Enrollment ID: I20080604000097 |
| Provider Name | Robert M Dowell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487818712 PECOS PAC ID: 9537234570 Enrollment ID: I20080826000471 |
| Provider Name | Marcia Jacobs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841446556 PECOS PAC ID: 4880744903 Enrollment ID: I20090611000439 |
| Provider Name | Mary A Hammonds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346565009 PECOS PAC ID: 3173648516 Enrollment ID: I20100909000115 |
| Provider Name | Sanjay P Thakur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699816074 PECOS PAC ID: 6709960776 Enrollment ID: I20100924000079 |
| Provider Name | Derek Riseden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508171372 PECOS PAC ID: 5597959718 Enrollment ID: I20101102000513 |
| Provider Name | Jennifer Clark Riseden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104107507 PECOS PAC ID: 0648442210 Enrollment ID: I20111004000844 |
| Provider Name | Amanda B Parks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235484668 PECOS PAC ID: 8921257510 Enrollment ID: I20120925000318 |
| Provider Name | Johnny R Rivers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992172399 PECOS PAC ID: 3375511728 Enrollment ID: I20151109000067 |
| Provider Name | Emily M Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982234209 PECOS PAC ID: 5799115168 Enrollment ID: I20200427001113 |
| Provider Name | Katherine Gresham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225652720 PECOS PAC ID: 6305261645 Enrollment ID: I20200804002724 |
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