Healthcare Provider Details

I. General information

NPI: 1063897627
Provider Name (Legal Business Name): COMMUNITY PAIN CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2015
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 N CEDAR BLUFF RD
KNOXVILLE TN
37923-2805
US

IV. Provider business mailing address

509 N CEDAR BLUFF RD
KNOXVILLE TN
37923-2805
US

V. Phone/Fax

Practice location:
  • Phone: 865-769-5388
  • Fax: 865-769-5391
Mailing address:
  • Phone: 865-769-5388
  • Fax: 865-769-5391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN19745
License Number StateTN

VIII. Authorized Official

Name: RILEY SENTER
Title or Position: MEDICAL DIRECTOR/OWNER
Credential:
Phone: 865-769-5388