Healthcare Provider Details

I. General information

NPI: 1336905561
Provider Name (Legal Business Name): TENNESSEE ORTHOPAEDIC ALLIANCE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SOUTH GATEWAY BLVD.
CLARKSVILLE TN
37043
US

IV. Provider business mailing address

PO BOX 306556
NASHVILLE TN
37230-6556
US

V. Phone/Fax

Practice location:
  • Phone: 931-552-4340
  • Fax: 931-552-0999
Mailing address:
  • Phone: 865-243-8183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHANNON L AIUTO
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 865-314-8114