MEDICARE: MR. JOHN B. DEAN PT, ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	01075	TN
2	2251S0007X	Sports Physical Therapist	07778	TN
3	225100000X	Physical Therapist	7778	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4277896	OTHER	TN	BLUECROSS BLUESHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811225410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN B. DEAN PT, ATC

Provider Business Mailing Address
First Line	:	8320 E WALKER SPRINGS LN STE 200
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-3120
Country	:	US
Telephone Number	:	865-769-4500
Fax Number	:	865-769-4501

Provider Business Practice Location Address
First Line	:	1551 LAKE LOUDON BLVD
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37916-4009
Country	:	US
Telephone Number	:	865-974-1900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2009
Last Update Date	:	01/14/2026

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