Provider Demographics
NPI:1386625846
Name:UNIVERSITY OF TENNESSEE
Entity type:Organization
Organization Name:UNIVERSITY OF TENNESSEE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE CHANCELLOR, COO
Authorized Official - Prefix:
Authorized Official - First Name:RAAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:KURAPATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-448-8030
Mailing Address - Street 1:600 HENLEY ST STE 213
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37996-4502
Mailing Address - Country:US
Mailing Address - Phone:865-974-5453
Mailing Address - Fax:865-974-1792
Practice Address - Street 1:600 HENLEY ST STE 213
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37996-0001
Practice Address - Country:US
Practice Address - Phone:865-974-5453
Practice Address - Fax:865-974-1792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN444-8104Medicaid
TN444-8104Medicaid
TN3713026Medicare ID - Type UnspecifiedPART B