| Medexpress - Ornl Oak Ridge | |
|
1 Bethel Valley Rd Oak Ridge TN 37830-8050 | |
| (865) 574-9355 | |
| (865) 574-9353 |
| Full Name | Medexpress - Ornl Oak Ridge |
|---|---|
| Speciality | General Practice |
| Location | 1 Bethel Valley Rd, Oak Ridge, Tennessee |
| Authorized Official Name and Position | Joy Kimball (CONTRACT MANAGER) |
| Authorized Official Contact | 7633496740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medexpress - Ornl Oak Ridge 423 Fortress Blvd Morgantown WV 26508-1351 Ph: (304) 225-2500 | Medexpress - Ornl Oak Ridge 1 Bethel Valley Rd Oak Ridge TN 37830-8050 Ph: (865) 574-9355 |
| NPI Number | 1013419522 |
|---|---|
| Provider Enumeration Date | 03/01/2018 |
| Last Update Date | 05/07/2024 |
| Certification Date | 05/07/2024 |
| Medicare PECOS PAC ID | 9537323118 |
|---|---|
| Medicare Enrollment ID | O20120611000626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013419522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (NU) | Primary |
| Provider Name | Guy L Smoak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649238791 PECOS PAC ID: 3971597899 Enrollment ID: I20040413001365 |
| Provider Name | Anastasia Z Rairigh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841451119 PECOS PAC ID: 3870755515 Enrollment ID: I20120425000828 |
| Provider Name | David R Ferrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376542290 PECOS PAC ID: 0345255311 Enrollment ID: I20120611000676 |
| Provider Name | Jordan R Digiovanni |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174039366 PECOS PAC ID: 4183979503 Enrollment ID: I20190122000865 |
| Provider Name | Phillip Carron |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033591375 PECOS PAC ID: 7719293174 Enrollment ID: I20190211001549 |
| Provider Name | Chelsea L Foust |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861952467 PECOS PAC ID: 2062741309 Enrollment ID: I20190911001499 |
| Provider Name | Patrick Denman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164759528 PECOS PAC ID: 7911042544 Enrollment ID: I20230524000628 |
| Provider Name | Jessica Brandt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811203169 PECOS PAC ID: 1951580299 Enrollment ID: I20260210000524 |
| Provider Name | John Crowe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093709057 PECOS PAC ID: 0345324018 Enrollment ID: I20260224000999 |
| Provider Name | Ramon Suarez Carmona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851778062 PECOS PAC ID: 8729317854 Enrollment ID: I20260602003809 |
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