=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487096376
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CW SPECIALTY CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/22/2013
-----------------------------------------------------
Last Update Date | 03/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5321 BEVERLY PARK CIR
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37918-9253
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-246-2104
-----------------------------------------------------
Fax | 865-246-2106
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4058 SCARLETT DR
-----------------------------------------------------
City | MORRISTOWN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37814-8101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-246-2104
-----------------------------------------------------
Fax | 865-246-2106
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PROVIDER
-----------------------------------------------------
Name | ANGELA WILLIAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 865-246-2104
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | APM0000017637
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------