Provider Demographics
NPI:1861543910
Name:NEPHROLOGY ASSOCIATES OF KNOXVILLE
Entity type:Organization
Organization Name:NEPHROLOGY ASSOCIATES OF KNOXVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RIVERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:865-546-9246
Mailing Address - Street 1:3734 MARTIN MILL PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920
Mailing Address - Country:US
Mailing Address - Phone:865-380-0803
Mailing Address - Fax:865-380-0609
Practice Address - Street 1:1851 CREST RD
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-4304
Practice Address - Country:US
Practice Address - Phone:865-380-0803
Practice Address - Fax:865-380-0609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3723987Medicare ID - Type Unspecified