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This Provider and Pharmacy Directory was updated in November 2017. For more information, please contact Cigna-HealthSpring Customer Service at 1-800-668-3813 or, for TTY users, 711, 7 days a week, 8 a.m. - 8 p.m., or visit www.cignahealthspring.com. Changes to our pharmacy network may occur during the benefit year. An updated Pharmacy Directory is located on our website at www.cignahealthspring.com. You may also call Customer Service for updated provider information. Este Directorio de proveedores y farmacias fue actualizado en noviembre de 2017. Para obtener más información, llame a Servicio al Cliente de Cigna al 1-800-668-3813 o, para los usuarios de TTY, al 711, los 7 días de la semana, de 8 a.m. a 8 p.m., o visite www.cignahealthspring.com. Es posible que, durante el año de beneficios, se realicen cambios en nuestra red de farmacias. Podrá encontrar un Directorio de farmacias actualizado en nuestro sitio web www.cignahealthspring.com. También puede llamar a Servicio al Cliente para obtener información actualizada sobre los proveedores. © 2017 Cigna 17_D_71_KNX_71 INT_17_50673BL Cigna-HealthSpring Knoxville Independent Tennessee Counties/Condados: Anderson, Blount, Campbell, Cocke, Cumberland, Grainger, Hamblen, Hancock, Jefferson, Knox, Loudon, Morgan, Putnam, Roane, Scott, Sevier, Union Directorio de farmacias y proveedores PROVIDER AND PHARMACY DIRECTORY PROVI 2017

PROVIDER 2017 PROVIDER AND PHARMACY DIRECTORY · This Provider and Pharmacy Directory was updated in November 2017. For more information, please contact Cigna-HealthSpring Customer

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  • This Provider and Pharmacy Directory was updated in November 2017. For more information, please contact Cigna-HealthSpring Customer Service at 1-800-668-3813 or, for TTY users, 711, 7 days a week, 8 a.m. - 8 p.m., or visit www.cignahealthspring.com. Changes to our pharmacy network may occur during the benefit year. An updated Pharmacy Directory is located on our website at www.cignahealthspring.com. You may also call Customer Service for updated provider information. Este Directorio de proveedores y farmacias fue actualizado en noviembre de 2017. Para obtener ms informacin, llame a Servicio al Cliente de Cigna al 1-800-668-3813 o, para los usuarios de TTY, al 711, los 7 das de la semana, de 8 a.m. a 8 p.m., o visite www.cignahealthspring.com. Es posible que, durante el ao de beneficios, se realicen cambios en nuestra red de farmacias. Podrencontrar un Directorio de farmacias actualizado en nuestro sitio web www.cignahealthspring.com. Tambin puede llamar a Servicio al Cliente para obtener informacin actualizada sobre los proveedores. 2017 Cigna 17_D_71_KNX_71 INT_17_50673BL

    Cigna-HealthSpring Knoxville IndependentTennessee Counties/Condados: Anderson, Blount, Campbell, Cocke, Cumberland, Grainger, Hamblen, Hancock, Jefferson, Knox, Loudon, Morgan, Putnam, Roane, Scott, Sevier, Union

    Directorio de farmacias y proveedores

    PROVIDER AND PHARMACY DIRECTORY

    PROVIDER 2017

    Cover Provider Pharmacy Directory KNX NOV PRINT.indd 1 2/15/17 1:57 PM

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    17_D_71_KNX_71

    Cigna-HealthSpring Provider and Pharmacy Provider Directory / Directorio de farmacias y proveedores

    Table of Contents / ndice Provider Directory ....................................................................................................................................................................... i Section 1 Introduction ..................................................................................................................................................................... ii

    Network Providers ......................................................................................................................................................................... iiSpecialists Referrals ................................................................................................................................................................... iiCigna-HealthSprings relationship with their Provider Network ...................................................................................................... iiiIf you should receive a full-cost bill from a provider ....................................................................................................................... iiiEmergency care/Urgent care ........................................................................................................................................................ iiiBehavioral Health Services .......................................................................................................................................................... ivWhat is the service area for Cigna-HealthSpring? ........................................................................................................................ ivHow do you find Cigna-HealthSpring providers in your area? ...................................................................................................... iv

    Section 2 List of Network Providers ................................................................................................................................................ vHow to use this directory to choose a Primary Care Provider ....................................................................................................... vHow to use this directory to choose a Specialist ........................................................................................................................... vHow to use this directory to choose a Provider that accepts both Medicare and Medicaid ........................................................... vHow to use this directory to choose other Plan Providers ............................................................................................................. vProvider Directory Symbol Key...................................................................................................................................................... vTotal Number of Providers within this Directory ............................................................................................................................ vi

    Directorio de proveedores ...................................................................................................................................................... viiSeccin 1 Introduccin ................................................................................................................................................................. viii

    Proveedores de la red ................................................................................................................................................................. viiiEspecialistas Referencias ........................................................................................................................................................ viiiRelacin de Cigna-HealthSpring con su Red de proveedores ..................................................................................................... ixSi recibe una factura por el costo total de un proveedor .............................................................................................................. ixAtencin de emergencia/de urgencia ........................................................................................................................................... ixServicios de salud del comportamiento ......................................................................................................................................... xCul es el rea de servicio para Cigna-HealthSpring? ................................................................................................................ xCmo puede encontrar proveedores de Cigna-HealthSpring en su rea? .................................................................................. x

    Seccin 2 Lista de proveedores de la red ...................................................................................................................................... xiCmo usar este directorio para elegir un Proveedor de atencin primaria ................................................................................... xi

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    Cmo usar este directorio para elegir un Especialista ................................................................................................................. xiCmo usar este directorio para elegir un Proveedor que acepte Medicare y Medicaid ................................................................ xiCmo usar este directorio para elegir otros Proveedores del plan ............................................................................................... xiExplicacin de smbolos del Directorio de proveedores ............................................................................................................... xiiCantidad total de proveedores de este directorio ......................................................................................................................... xii

    Network Provider Listing Table of Contents / Listado de proveedores de la red ndice .......................... xiii2017 Pharmacy Directory .....................................................................................................................................................Directorio de farmacias 2017 ..............................................................................................................................................

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    Cigna-HealthSpring HMO Plan Provider Directory

    This directory provides a list of Cigna-HealthSprings network providers. This directory is for Tennessee Counties: Anderson, Blount, Campbell, Cocke, Cumberland, Grainger, Hamblen, Hancock, Jefferson, Knox, Loudon, Morgan, Putnam, Roane, Scott, Sevier and Union.

    All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Cigna HealthCare of South Carolina, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Arizona, Inc., Cigna HealthCare of St. Louis, Inc., HealthSpring Life & Health Insurance Company, Inc., HealthSpring of Tennessee, Inc., HealthSpring of Alabama, Inc., HealthSpring of Florida, Inc., Bravo Health Mid-Atlantic, Inc., and Bravo Health Pennsylvania, Inc. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. Cigna-HealthSpring is contracted with Medicare for PDP plans, HMO and PPO plans in select states, and with select State Medicaid programs. Enrollment in Cigna-HealthSpring depends on contract renewal. The pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. This information is available for free in other languages. Please call our customer services number at 1-800-668-3813 (TTY 711), 7 days a week, 8 a.m. - 8 p.m. Esta informacin est disponible de forma gratuita en otros idiomas. Por favor, llame a nuestro servicio al cliente al 1-800-668-3813 (TTY 711), 7 das de la semana, 8 a.m. - 8 p.m. This document may be available in other formats such as Braille, large print or other alternate formats. Contact the plan for more information. INT_17_50673BL 11292016

    This directory is current as of November 2017. Some network providers may have been added or removed from our network afterthis directory was printed. We do not guarantee that each provider is still accepting new customers. To get the most up-to-dateinformation about Cigna-HealthSprings network providers in your area, you can visit www.cignahealthspring.com or call ourCustomer Service Department at 1-800-668-3813, October 1 February 14, 8:00 a.m. 8:00 p.m. local time, 7 days a week.From February 15 September 30, Monday Friday 8:00 a.m. 8:00 p.m. local time, Saturday 8:00 a.m. 6:00 p.m. local time.Messaging service used weekends, after hours, and on federal holidays. TTY users should call 711.

  • ii

    Section 1 Introduction Network Providers This directory provides a list of Cigna-HealthSprings network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage. You will have to choose one of our network providers who are listed in this directory to be your Primary Care Provider (PCP). The term PCP will be used throughout this directory. Generally, you must get your health care services from your PCP. Your PCP is a physician who is trained to provide general medical care. Your PCP can also coordinate the rest of the covered services you need. The network providers listed in this directory have agreed to provide you with your health care, vision and dental services. Please note: Not all Cigna-HealthSpring plans have vision and dental benefits. Please check your Evidence of Coverage to see if your plan has a vision and/or dental benefit. You may go to any of our network providers listed in this directory; however, some services may require a referral. If you have been going to one network provider, you are not required to continue to go to that same provider. In some cases, you may get covered services from non-network providers. Other physicians/providers are available in our network. Specialists Referrals Even though your PCP is trained to handle the majority of common health needs, there may be a time when you need more specialized treatment. In those situations, you may see a plan specialist. Specialists are doctors who are trained to provide health services for a specific disease or part of the body. For some types of specialists, you will need to obtain a referral from your PCP before you can schedule an appointment with the specialist. Below is a list of provider specialty types that require referrals from your PCP before you can schedule an appointment with them. Please note: Some provider types may have been added or removed from the list after this directory was printed. You should check with your PCP or call Customer Service at the phone number on the cover to see if a referral is required to see a specialist or other provider. Note that a referral is different from prior authorization, which is required before certain services or procedures can be performed.

    Allergy & Immunology Anesthesiology Audiology Cardiovascular Disease Cardiovascular Surgery Chiropractor Colon and Rectal Surgery Dermatology Endocrinology Gastroenterology General Surgery Gynecologic Oncology Hand Surgery Hematology Hematology/Oncology Infectious Disease Maxillofacial Surgery

    Medical Genetics Medical Oncology Nephrology Neurosurgery Neurology Occupational Therapy Ophthalmology Oral Surgery Orthopedic Surgery Otolaryngology Pain Management Pediatric Cardiology Pediatric Endocrinology Pediatric Hematology-Oncology Pediatric Rehabilitation Medicine Pediatric Surgery Physical Medicine/Rehabilitation

    Physical Therapy Plastic Surgery Podiatry Proctology Prosthodontics Pulmonary Disease Radiology Respiration Therapy Rheumatology Speech Language Pathologist Speech Therapy Sports Medicine Thoracic Surgery Urology Vascular and Interventional Vascular Surgery

  • iii

    In addition, each PCP has certain plan specialists and hospitals they use for referrals. This means that the Cigna-HealthSpring specialists or hospitals you can use may depend on which PCP you select. If there are specialists or hospitals that you want to use, it is important to find out if your chosen PCP refers to them. Cigna-HealthSprings relationship with their Provider Network Cigna-HealthSpring has different types of Primary Care Provider relationships. We have contracts with independent physicians and clinic-based providers in your area. The following paragraph describes the relationship these providers have with Cigna-HealthSpring.

    Independent physicians Independent physicians are Primary Care and Specialist physicians located in and around your area that are not part of an Independent Physician Associations (IPA) or Physician Organized Delivery system (POD). If you select an independent Primary Care Physician you should be aware that your PCP will refer you to specialists and hospitals with whom he/she is affiliated and with whom they work closely to coordinate your care. Please confirm whether the referred physician or hospital is a network provider with your plan. You will receive all of your care, including gynecological and specialty care from the physicians affiliated with your PCP. Gynecological care can be accessed through any independent Gynecologist.

    If you should receive a full-cost bill from a provider There may also be times when you get a bill from a provider for the full cost of medical care you have received. In many cases, you should contact Customer Service or send this bill to us instead of paying it. We will look at the bill and decide whether the services should be covered. If we decide they should be covered, we will pay the provider directly. (Please note that we cannot pay a provider who has opted out of the Medicare program. Check with your provider before receiving services to confirm that they have not opted out of Medicare.) If we determine that the services are not covered or were not medically necessary, we may deny coverage and you will be responsible for the entire cost. Emergency care/Urgent care You may get emergency medical care whenever you need it, anywhere in the United States or its territories. Our plan covers ambulance services in situations where getting to the emergency room in any other way could endanger your health. Please refer to your Evidence of Coverage for details. You may get covered emergency medical care whenever you need it, anywhere in the world. If you have an emergency, we will talk with the doctors who are giving you emergency care to help manage and follow up on your care. The doctors who are giving you emergency care will decide when your condition is stable and the medical emergency is over. After the emergency is over you are entitled to follow-up care to be sure your condition continues to be stable. Your follow-up care will be covered by our plan. If your emergency care is provided by out-of-network providers, we will try to arrange for network providers to take over your care as soon as your medical condition and the circumstances allow. You must use plan providers except in emergency or urgent care situations. If you obtain routine care from out-of-network providers neither Medicare nor Cigna-HealthSpring will be responsible for the costs.

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    Behavioral Health Services Behavioral health services, including mental health and substance abuse services, for beneficiaries covered by Cigna-HealthSpring are provided through Cigna-HealthSpring Behavioral Healthcare Services. Customers and providers may access Cigna-HealthSpring Behavioral Healthcare Services by calling 1-866-780-8546 (TTY 711) for assistance in finding a behavioral health care professional or to arrange for inpatient admission authorization. Cigna-HealthSpring Behavioral Healthcare Services is available 24 hours per day, 7 days a week. What is the service area for Cigna-HealthSpring? The counties in our service area are listed below.

    Tennessee Counties: Anderson, Blount, Campbell, Cocke, Cumberland, Grainger, Hamblen, Hancock, Jefferson, Knox, Loudon, Morgan, Putnam, Roane, Scott, Sevier and Union

    How do you find Cigna-HealthSpring providers in your area? To choose a PCP from the Provider Directory, turn to the Primary Care Provider section for a listing of primary care providers in your area. You can also call Customer Service at the number listed below for assistance. When you select a PCP, you will find a space on your Enrollment Application to enter the PCPs name. If you choose a PCP after your Enrollment Application has been submitted, call Customer Service and inform them of your PCP selection. Please keep in mind that if you do not select a PCP at the time of enrollment, Cigna-HealthSpring will select one for you based on where you live. If you want to change to another PCP, you may do so at any time by calling Customer Service at the number listed below. The name and office telephone number of your PCP are printed on your ID card. To choose a specialist, hospital, pharmacy or other provider, please turn to the applicable section in the Provider Directory for a listing of providers in your area. For example, to find hospitals in your area, turn to the Hospitals section of the directory. If you have questions about Cigna-HealthSpring or require assistance in selecting a PCP, please call our Customer Service Department at 1-800-668-3813, October 1 February 14, 8:00 a.m. 8:00 p.m. local time, 7 days a week. From February 15 September 30, Monday Friday 8:00 a.m. 8:00 p.m. local time, Saturday 8:00 a.m. 6:00 p.m. local time. Messaging service used weekends, after hours, and on federal holidays. TTY users should call 711 or visit www.cignahealthspring.com. Again, if you want to use a particular Cigna-HealthSpring specialist or hospital, you should check with your PCP to make sure they can make referrals to that specialist or hospital. The providers listed in this directory are part of a sub-network of Cigna-HealthSpring providers. You are not limited to the providers in this directory and can get the most-up-to-date list of all available providers in your area by calling Customer Service at 1-800-668-3813 (TTY 711), October 1 February 14, 8:00 a.m. 8:00 p.m. local time, 7 days a week. From February 15 September 30, Monday Friday 8:00 a.m. 8:00 p.m. local time, Saturday 8:00 a.m. 6:00 p.m. local time or by visiting our website at www.cignahealthspring.com. A hard copy directory is also available by request.

  • v

    Section 2 List of Network Providers This directory is organized to help you find the type of provider you need. Providers are listed in the following sections:

    - Independent Providers o Primary Care Provider (PCP) o Specialists o Podiatrists o Hospitals o Psychiatric Hospitals o Skilled Nursing Facilities o Behavioral Health Providers o Ambulatory Surgical Centers/Urgent Care Facilities o Ancillary Providers o Dental Providers o Vision Providers

    How to use this directory to choose a Primary Care Provider There are two ways to select a primary care provider:

    - You can choose a particular Primary Care Provider by name; or - You can choose your Primary Care Provider by location.

    If you are looking for a particular Primary Care Provider by name: 1. Go to the Alphabetical Index, which is the last section of the directory. 2. Find the doctor by last name and the page number(s) on which he or she is listed. 3. Go to that page number for information on the Primary Care Provider.

    If you are looking for a Primary Care Provider by location: 1. Go to the Primary Care Provider section. 2. Find the city and/or zip code. 3. Select a Provider.

    How to use this directory to choose a Specialist Specialist physicians and other primary care providers in this directory are listed by specialty of care, followed by geographic location, and name. How to use this directory to choose a Provider that accepts both Medicare and Medicaid Plan providers that accept both Medicare and Medicaid are located throughout this Provider Directory and are marked by an asterisk (*).

    For example, this provider would be a Medicare and Medicaid provider: Dr. John Doe* However, this provider would not be a Medicare and Medicaid provider: Dr. Jane Doe

    How to use this directory to choose other Plan Providers Plan providers in this directory, other than primary care providers and specialists, are listed by geographic location then the name of the provider. Provider Directory Symbol Key In this directory, some providers will have a symbol at the end of their name. Below are the symbols and what they mean:

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    Symbol Meaning

    * Accepts Medicare and Medicaid Accepting Existing Patients Only Not Accepting New Patients

    Total Number of Providers within this Directory:

    Primary Care Providers (PCP): 332Specialists: 2363Hospitals: 18Skilled Nursing Facilities: 49Behavioral Health Providers: 297Ambulatory Surgical Centers / Urgent Care Facilities: 28Ancillary Providers: 287Dental Providers: 1Vision Providers: 135Pharmacies: 367

  • vii

    Directorio de proveedores de planes HMO de Cigna-HealthSpring

    Este directorio proporciona una lista de proveedores de la red de Cigna-HealthSpring. Este directorio es para los siguientes condados de Tennessee: Anderson, Blount, Campbell, Cocke, Cumberland, Grainger, Hamblen, Hancock, Jefferson, Knox, Loudon, Morgan, Putnam, Roane, Scott, Sevier y Union.

    Todos los productos y servicios de Cigna se brindan exclusivamente por o a travs de subsidiarias operativas de Cigna Corporation, incluyendo Cigna Health and Life Insurance Company, Cigna HealthCare of South Carolina, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Arizona, Inc., Cigna HealthCare of St. Louis, Inc., HealthSpring Life & Health Insurance Company, Inc., HealthSpring of Tennessee, Inc., HealthSpring of Alabama, Inc., HealthSpring of Florida, Inc., Bravo Health Mid-Atlantic, Inc. y Bravo Health Pennsylvania, Inc. El nombre de Cigna, los logotipos, y otras marcas de Cigna son propiedad de Cigna Intellectual Property, Inc. Cigna-HealthSpring tiene contrato con Medicare para planes PDP, planes HMO y PPO en ciertos estados, y con ciertos programas estatales de Medicaid. La inscripcin en Cigna-HealthSpring depende de la renovacin de contrato. La red de farmacias o la red de proveedores pueden cambiar en cualquier momento. Recibir una notificacin cuando sea necesario. This information is available for free in other languages. Please call our customer service number at 1-800-668-3813 (TTY 711), 7 days a week, 8 a.m. 8 p.m. Esta informacin est disponible de forma gratuita en otros idiomas. Por favor, llame a nuestro servicio al cliente al 1-800-668-3813 (TTY 711), los 7 das de la semana, de 8 a.m. a 8 p.m. Es posible que este documento est disponible en otros formatos, como braille, letra grande u otros formatos alternativos. Para ms informacin pngase en contacto con el plan. INT_17_50673BL 11292016

    Este directorio est actualizado a noviembre de 2017. Es posible que se hayan agregado o eliminado algunos proveedores denuestra red desde la fecha de impresin de este directorio. No garantizamos que todos los proveedores sigan aceptando nuevosafiliados. Para obtener la informacin ms actualizada sobre los proveedores de la red de Cigna-HealthSpring en su rea, puedevisitar www.cigna.healthspring.com o llamar a nuestro Departamento de Servicio al Cliente al 1-800-668-3813, del 1 de octubre al14 de febrero, de 8 a.m. a 8 p.m., hora local, los 7 das de la semana. Del 15 de febrero al 30 de septiembre, de lunes a viernes,de 8 a.m. a 8 p.m., hora local; los sbados, de 8 a.m. a 6 p.m., hora local. Se usa un servicio de mensajes los fines de semana,fuera del horario de atencin y en los das festivos federales. Los usuarios de TTY deben llamar al 711.

  • viii

    Seccin 1 Introduccin Proveedores de la red Este directorio proporciona una lista de proveedores de la red de Cigna-HealthSpring. Para obtener informacin detallada sobre su cobertura de atencin mdica, consulte su Evidencia de cobertura. Deber elegir uno de los proveedores de nuestra red que figuran en este directorio como su Proveedor de atencin primaria (PCP, por sus siglas en ingls). El trmino PCP se usar en todo este directorio. Por lo general, usted deber obtener sus servicios de atencin mdica por medio de su PCP. Su PCP es un mdico que est capacitado para brindar atencin mdica general. Su PCP tambin podr coordinar el resto de los servicios cubiertos que usted necesite. Los proveedores de la red que figuran en este directorio han aceptado brindarle servicios de atencin mdica, de la vista y dentales. Tenga en cuenta que: No todos los planes de Cigna-HealthSpring tienen beneficios dentales y de la vista. Consulte su Evidencia de cobertura para ver si su plan tiene un beneficio de la vista o dental. Puede dirigirse a cualquiera de los proveedores de nuestra red que figuran en este directorio; sin embargo, para algunos servicios es posible que necesite una referencia. Si viene visitando a un proveedor de la red, no tiene obligacin de seguir visitando a ese mismo proveedor. En algunos casos, puede recibir servicios cubiertos de proveedores no pertenecientes a la red. Nuestra red incluye otros mdicos/proveedores. Especialistas Referencias Aunque su PCP est capacitado para manejar la mayora de las necesidades mdicas comunes, es posible que en algunas ocasiones usted necesite tratamiento ms especializado. En esas situaciones, podr consultar a un especialista del plan. Los especialistas son mdicos que estn capacitados para brindar servicios de salud para una enfermedad o una parte del cuerpo especfica. Para algunos tipos de especialistas, deber obtener una referencia de su PCP antes de poder programar una cita con el especialista. A continuacin encontrar una lista de los tipos de especialidades de los proveedores para los que se necesitan referencias de su PCP antes de que pueda programar una cita con ellos. Tenga en cuenta que: Es posible que se hayan agregado o eliminado algunos tipos de proveedores de la lista desde la fecha de impresin de este directorio. Debera consultar a su PCP o llamar a Servicio al Cliente al nmero de telfono que figura en la portada para ver si se necesita una referencia para consultar a un especialista u otro proveedor. Tenga en cuenta que una referencia es diferente de la autorizacin previa, que se requiere antes de que puedan realizarse determinados servicios o procedimientos.

    Alergia e Inmunologa Anestesiologa Audiologa Enfermedad Cardiovascular Ciruga cardiovascular Quiroprctico Ciruga de colon y recto Dermatologa Endocrinologa Gastroenterologa Ciruga General Oncologa Ginecolgica Ciruga de mano Hematologa Hematologa/Oncologa Enfermedades infecciosas Ciruga maxilofacial

    Gentica Mdica Oncologa Mdica Nefrologa Neurociruga Neurologa Terapia ocupacional Oftalmologa Ciruga bucal Ciruga ortopdica Otolaringologa Control del dolor Cardiologa Peditrica Endocrinologa Peditrica Hematologa-Oncologa Peditrica Medicina de Rehabilitacin Peditrica Ciruga Peditrica Medicina Fsica/Rehabilitacin

    Fisioterapia Ciruga plstica Podiatra Proctologa Prtesis dentales Enfermedad pulmonar Radiologa Terapia Respiratoria Reumatologa Patlogo del habla-del lenguaje Terapia del habla Medicina Deportiva Ciruga torcica Urologa Vascular e Intervencionista Ciruga vascular

  • ix

    Adems, cada PCP tiene determinados especialistas y hospitales del plan que usa para las referencias. Esto significa que los especialistas u hospitales de Cigna-HealthSpring que usted pueda usar pueden depender del PCP que elija. Si usted desea usar determinados especialistas u hospitales, es importante que averige si el PCP que ha elegido da referencias para ellos. Relacin de Cigna-HealthSpring con su Red de proveedores Cigna-HealthSpring tiene diferentes tipos de relaciones con los Proveedores de atencin primaria. Tenemos contratos con mdicos independientes y proveedores que atienden en clnicas de su rea. El siguiente prrafo describe la relacin que tienen estos proveedores con Cigna-HealthSpring.

    Mdicos independientes Los mdicos independientes son mdicos de atencin primaria y especialistas que atienden en su rea y en los alrededores que no forman parte de una Asociacin de Mdicos Independientes (IPA, por sus siglas en ingls) o un sistema de Prestacin Organizada de Mdicos (POD, por sus siglas en ingls). Si usted elige un Mdico de atencin primaria independiente, debe saber que su PCP lo referir a especialistas y hospitales con los que est afiliado y con los cuales trabaja en estrecha colaboracin para coordinar su atencin. Confirme si el mdico u hospital referido es un proveedor de la red de su plan. Recibir toda su atencin, incluida la atencin ginecolgica y especializada, de mdicos afiliados a su PCP. Puede acceder a atencin ginecolgica a travs de cualquier Gineclogo independiente.

    Si recibe una factura por el costo total de un proveedor Tambin puede haber ocasiones en que reciba una factura de un proveedor por el costo total de la atencin mdica que recibi. En muchos casos, debe comunicarse con Servicio al Cliente o enviarnos esta factura en lugar de pagarla. Nosotros analizaremos la factura y decidiremos si los servicios se deben cubrir. Si decidimos que se deben cubrir, le pagaremos directamente al proveedor. (Tenga en cuenta que no podemos pagarle a un proveedor que ha optado por quedar excluido del programa Medicare. Consulte a su proveedor antes de recibir servicios para confirmar que no haya optado por quedar excluido de Medicare). Si determinamos que los servicios no estn cubiertos o que no eran mdicamente necesarios, es posible que deneguemos la cobertura, y usted ser responsable del costo total. Atencin de emergencia/de urgencia Usted puede recibir atencin mdica de emergencia cuando la necesite, en cualquier lugar de los Estados Unidos o de sus territorios. Nuestro plan cubre servicios de ambulancia en situaciones en las que llegar a la sala de emergencias de otra forma podra poner en peligro su salud. Consulte su Evidencia de cobertura para conocer detalles. Usted puede recibir atencin mdica de emergencia cubierta cuando la necesite en cualquier lugar del mundo. Si tiene una emergencia, hablaremos con los mdicos que le estn brindando la atencin de emergencia para ayudar con la administracin y el seguimiento de su atencin. Los mdicos que le estn brindando atencin de emergencia determinarn cundo su afeccin est estable y ha finalizado la emergencia mdica. Una vez finalizada la emergencia, usted tiene derecho a recibir atencin de seguimiento para asegurarse de que su afeccin se mantenga estable. Nuestro plan cubrir su atencin de seguimiento. Si la atencin de su emergencia es proporcionada por proveedores fuera de la red, intentaremos coordinar que proveedores de la red se hagan cargo de su atencin tan pronto como su situacin mdica y las circunstancias lo permitan. Debe usar proveedores del plan, salvo en situaciones de atencin de emergencia o de urgencia. Si obtiene atencin de rutina de proveedores no pertenecientes a la red, ni Medicare ni Cigna-HealthSpring se harn cargo de los costos.

  • x

    Servicios de salud del comportamiento Los servicios de salud del comportamiento, incluidos los servicios de salud mental y abuso de sustancias, para beneficiarios cubiertos por Cigna-HealthSpring se brindan a travs de los servicios de Salud del Comportamiento de Cigna-HealthSpring. Los afiliados y proveedores pueden acceder a los servicios de Salud del Comportamiento de Cigna-HealthSpring llamando al 1-866-780-8546 (TTY 711) para recibir asistencia para encontrar un profesional de atencin de la salud del comportamiento o para coordinar la autorizacin para una admisin como paciente internado. Los servicios de Salud del Comportamiento de Cigna-HealthSpring estn disponibles las 24 horas del da, los 7 das de la semana. Cul es el rea de servicio para Cigna-HealthSpring? Los condados de nuestra rea de servicio se enumeran a continuacin.

    Condados de Tennessee: Anderson, Blount, Campbell, Cocke, Cumberland, Grainger, Hamblen, Hancock, Jefferson, Knox, Loudon, Morgan, Putnam, Roane, Scott, Sevier y Union

    Cmo puede encontrar proveedores de Cigna-HealthSpring en su rea? Para elegir un PCP del Directorio de proveedores, consulte la seccin Proveedores de atencin primaria para ver un listado de los proveedores de atencin primaria en su rea. Tambin puede llamar a Servicio al Cliente al nmero indicado a continuacin para pedir asistencia. Cuando usted elija un PCP, encontrar un espacio en su Solicitud de inscripcin donde podr ingresar el nombre del PCP. Si elige un PCP despus de presentada su Solicitud de inscripcin, llame a Servicio al Cliente e infrmeles acerca de la eleccin de su PCP. Tenga en cuenta que si usted no elige un PCP al momento de la inscripcin, Cigna-HealthSpring elegir uno por usted segn el lugar donde usted viva. Si quiere cambiar por otro PCP, podr hacerlo en cualquier momento llamando a Servicio al Cliente al nmero indicado a continuacin. El nombre y el nmero de telfono del consultorio de su PCP estn impresos en su tarjeta de identificacin. Para elegir un especialista, hospital, farmacia u otro proveedor, consulte la seccin correspondiente del Directorio de proveedores para ver un listado de los proveedores de su rea. Por ejemplo, para encontrar hospitales en su rea, consulte la seccin Hospitales del directorio. Si tiene preguntas sobre Cigna-HealthSpring o necesita asistencia para elegir un PCP, llame a nuestro Departamento de Servicio al Cliente al 1-800-668-3813, del 1 de octubre al 14 de febrero, de 8 a.m. a 8 p.m., hora local, los 7 das de la semana. Del 15 de febrero al 30 de septiembre, de lunes a viernes, de 8 a.m. a 8 p.m., hora local; los sbados, de 8 a.m. a 6 p.m., hora local. Se usa un servicio de mensajes los fines de semana, fuera del horario de atencin y en los das festivos federales. Los usuarios de TTY deben llamar al 711 o visitar www.cignahealthspring.com. Nuevamente, si desea usar un especialista u hospital de Cigna-HealthSpring en particular, debe consultar a su PCP para asegurarse de que pueda otorgar referencias para ese especialista u hospital. Los proveedores que figuran en este directorio forman parte de una subred de proveedores de Cigna-HealthSpring. Usted no est limitado a los proveedores de este directorio y puede obtener la lista ms actualizada de todos los proveedores disponibles en su rea llamando a Servicio al Cliente al 1-800-668-3813 (TTY 711), del 1 de octubre al 14 de febrero, de 8:00 a.m. a 8:00 p.m., hora local, los 7 das de la semana. Del 15 de febrero al 30 de septiembre, de lunes a viernes, de 8 a.m. a 8 p.m., hora local; los sbados, de 8 a.m. a 6 p.m., hora local, o visitando nuestro sitio web en www.cignahealthspring.com. Tambin podr obtener un directorio impreso si lo solicita.

  • xi

    Seccin 2 Lista de proveedores de la red Este directorio est organizado para ayudarle a encontrar el tipo de proveedor que necesite. Los proveedores se enumeran en las siguientes secciones:

    - Proveedores independientes o Proveedor de atencin primaria (PCP) o Especialistas o Podiatras o Hospitales o Hospitales psiquitricos o Instalaciones de cuidados especiales o Proveedores de servicios de salud del comportamiento o Centros quirrgicos ambulatorios/Instalaciones de atencin de urgencia o Proveedores auxiliares o Proveedores de servicios dentales o Proveedores de atencin de la vista

    Cmo usar este directorio para elegir un Proveedor de atencin primaria Hay dos maneras de elegir un proveedor de atencin primaria:

    - Puede elegir un Proveedor de atencin primaria en particular por nombre, o - Puede elegir a su Proveedor de atencin primaria por ubicacin.

    Si est buscando un Proveedor de atencin primaria en particular por nombre: 1. Vaya al ndice alfabtico, que es la ltima seccin del directorio. 2. Busque el mdico por su apellido y el nmero de pgina en el que aparece. 3. Vaya a ese nmero de pgina para encontrar informacin sobre el Proveedor de atencin primaria.

    Si est buscando un Proveedor de atencin primaria por ubicacin: 1. Vaya a la seccin Proveedores de atencin primaria. 2. Busque la ciudad o el cdigo postal. 3. Elija un Proveedor.

    Cmo usar este directorio para elegir un Especialista Los mdicos especialistas y otros proveedores de atencin primaria de este directorio aparecen por especialidad de atencin, seguida de la ubicacin geogrfica y el nombre. Cmo usar este directorio para elegir un Proveedor que acepte Medicare y Medicaid Los proveedores del plan que aceptan Medicare y Medicaid estn ubicados en todo este Directorio de proveedores y estn marcados con un asterisco (*).

    Por ejemplo, este proveedor sera un proveedor de Medicare y Medicaid: Dr. John Doe* Sin embargo, este proveedor no sera un proveedor de Medicare y Medicaid: Dr. Jane Doe

    Cmo usar este directorio para elegir otros Proveedores del plan Los proveedores del plan de este directorio, que no sean los proveedores de atencin primaria y especialistas, aparecen por ubicacin geogrfica, seguida del nombre del proveedor.

  • xii

    Explicacin de smbolos del Directorio de proveedores En este directorio, algunos proveedores tendrn un smbolo al final de su nombre. A continuacin aparecen los smbolos y lo que significan:

    Smbolo Significado * Acepta Medicare y Medicaid Acepta pacientes actuales solamente No acepta pacientes nuevos

    Cantidad total de proveedores de este directorio:

    Proveedores de atencin primaria (PCP): 332Especialistas: 2363Hospitales: 18Centros de Enfermeria Especializada: 49Proveedores de servicios de salud del comportamiento: 297Centros quirrgicos ambulatorios/Instalaciones de atencin de urgencia: 28Proveedores auxiliares: 287Proveedores de servicios dentales: 1Proveedores de atencin de la vista: 135Farmacias: 367

  • xiii

    Provider Directory / Directorio de proveedoresPhysician Organized Delivery System (POD) / Sistema de Prestacin Organizada de Mdicos (POD)

    Knoxville CovenantPrimary Care Providers (PCP) / Proveedores de atencin primaria (PCP)...............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................1

    Independent Provider / Los proveedores independientesPrimary Care Providers (PCP) / Proveedores de atencin primaria (PCP).......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................4Specialists / Especialistas..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................14

    Hospitals / Hospitales...............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................91Skilled Nursing Facilities / Centros de Enfermeria Especializada.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................92Behavioral Health Providers / Proveedores de servicios de salud del comportamiento........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................94Ambulatory Surgical Centers / Urgent Care Facilities / Centros quirrgicos ambulatorios/Instalaciones de atencinde urgencia.....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................103Ancillary Providers / Proveedores auxiliares........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................104Dental Providers / Proveedores de servicios dentales...............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................113Vision Providers / Proveedores de atencin de la vista.............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................114Cigna-HealthSprings Network Pharmacies / Farmacias de la red de Cigna-HealthSpring

    Retail Pharmacies, including Chain Pharmacies / Farmacias minoristas, incluidas cadenas de farmacias...........................................................................................................................................................................................................................................................................120Mail Order Pharmacies / Farmacias de pedido por correo......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................126Home Infusion Pharmacies / Farmacias de terapia de infusin en el hogar................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................127Long-Term Care Pharmacies / Farmacias de cuidados a largo plazo...........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................129

    Index / ndice...........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................133Group Name Index / Grupo ndice de nombres.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................145Network Affiliation Index / ndice de afiliacin de red...............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................150Language Index / ndice de idioma...........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................151Pharmacy Index / ndice de Farmacia................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................152

    Network Provider Listing Table of Contents / Listado de proveedores de la red ndice

  • Physician OrganizedDelivery System (POD) /Sistema de PrestacinOrganizada de Mdicos

    (POD)Knoxville Covenant

    AndersonPrimary Care Providers(PCP) / Proveedores deatencin primaria (PCP)

    Family Medicine / MedicinaFamiliar

    Azel, Elizabeth T MDClinton Family Physician100 Vermont AvenueOak Ridge, TN 37830(865) 482-1777QMP000004127302Bingham, William B MDClinton Family Physician103 Bennett RoadOliver Springs, TN 37840(865) 435-1933HSPCP0000003049Carter, Ann D MD*Clinton Family Physician100 Vermont AvenueBldg A Suite 202Oak Ridge, TN 37830(865) 835-5138HSPCP0000005300Carter, Ann D MD*Clinton Family Physician100 Vermont AvenueOak Ridge, TN 37830(865) 482-1777HSPCP0000005300Daugherty, John T MDClinton Family Physician110 Executive Park DriveClinton, TN 37716(865) 494-9241HSPCP0000004613Gupton, Henry L MDClinton Family Physician110 Executive Park DriveClinton, TN 37716(865) 494-9247HSSPC0000032227

    Lucas, Sasha B MDClinton Family Physician102 South Charles G SeiversBlvdClinton, TN 37716(865) 457-4702QMP000004280855McNeeley, Edward T MDClinton Family Physician110 Executive Park DriveClinton, TN 37716(865) 494-9241B03998McNeeley, Howard BensleyMD*Clinton Family Physician110 Executive Park DriveClinton, TN 37716(865) 494-9241QMP000003584354Rachael, Stephen T MD*Clinton Family Physician100 Vermont AvenueOak Ridge, TN 37830(865) 482-1777QMP000004295816Terrell, Thomas R MDClinton Family Physician110 Executive Park DriveClinton, TN 37716(865) 494-9241QMP000004286604Internal Medicine / Medicina

    InternaGallian, Richard S MD*Clinton Family Physician100 Vermont AvenueOak Ridge, TN 37830(865) 482-1777HSSPC0000006821

    BlountFamily Medicine / Medicina

    FamiliarNash, Barrington N MD*Clinton Family Physician1921 Topside RoadSuite 200Louisville, TN 37777(865) 374-0450HSPCP0000004178

    ClaiborneInternal Medicine / Medicina

    InternaAnderson, Daniel M DO*Clinton Family Physician1610 Tazwell RoadSuite 201Tazewell, TN 37879(423) 626-8393QMP000004359571Neal, Brent Sheldon MDClinton Family Physician1610 Tazewell RoadSuite 201Tazewell, TN 37879(423) 626-8393QMP000003602900

    CumberlandFamily Medicine / Medicina

    FamiliarCarpenter, Douglas R MD*Clinton Family Physician100 Lantana RoadSuite 202Crossville, TN 38555(931) 484-5141QMP000003536394Carpenter, Douglas R MD*Clinton Family Physician132 Stonehenge DriveBldg A Suite 202Crossville, TN 38558(931) 484-5141QMP000003536394Carpenter, Douglas R MD*Clinton Family Physician60 Crossville Medical DriveSuite 109Crossville, TN 38555(931) 484-5141QMP000003536394

    General Practice / PrcticaGeneral

    Willett, Dwight H MD*Wyndridge Health andRehabilitation Center456 Wayne AvenueCrossville, TN 38555(931) 484-6129QMP000003547248

    Internal Medicine / MedicinaInterna

    Collins, Tamara J MDClinton Family Physician133 Hayes StreetCrossville, TN 38555(931) 456-9434HSSPC0000042785Collins, Tamara J MDClinton Family Physician132 Stonehenge DriveBldg A Suite 202Crossville, TN 38558(931) 484-5141Language(s): SpanishHSSPC0000042785Collins, Tamara J MDClinton Family Physician100 Lantana RoadSuite 202Crossville, TN 38555(931) 484-5141Language(s): SpanishHSSPC0000042785

    HamblenFamily Medicine / Medicina

    FamiliarSchindler, James B MD*Hamblen Primary Care1633 W Morris BlvdMorristown, TN 37813(423) 492-6700HSPCP0000000525

    KnoxFamily Medicine / Medicina

    FamiliarBrooks, George B MD*Clinton Family Physician8707 Asheville HwyKnoxville, TN 37924(865) 933-4159QMP000003717504Caldwell-Chor, Kelly MD*Clinton Family Physician10810 Parkside DriveSuite G11Knoxville, TN 37934(865) 271-6600HSPCP0000004790

    Knoxville CovenantPrimary Care Providers (PCP) / Proveedores de atencin primaria (PCP)

    1*Accepts Medicare and Medicaid Accepting Existing Patients Only Not Accepting New Patients*Acepta Medicare y Medicaid Acepta pacientes actuales solamente No acepta pacientes nuevos

  • Knox (cont.)Family Medicine / Medicina

    Familiar (cont.)Hicks, James S MD*Clinton Family Physician1300 Old Weisgarber RoadKnoxville, TN 37909(865) 584-2146HSPCP0000002721Hicks, James S MD*Clinton Family Physician1320 Old Weisgarber RoadKnoxville, TN 37909(865) 584-1054Language(s): FrenchHSPCP0000002721Howell, James P MD*Clinton Family Physician1300 Old Weisgarber RoadKnoxville, TN 37909(865) 584-2146QMP000004295819Kasprzak, Robert C DO*Clinton Family Physician1300 Old Weisgarber RoadKnoxville, TN 37909(865) 584-2146HSPCP0000003583Laman, Craig A DO*Clinton Family Physician8707 Asheville HwyKnoxville, TN 37924(865) 933-4159QMP000003497860McMichael, Jeffrey A MD*Clinton Family Physician1300 Old Weisgarber RoadKnoxville, TN 37909(865) 558-2146QMP000003581973Murff, Ronald E MD*Clinton Family Physician1300 Old Weisgarber RoadKnoxville, TN 37909(865) 584-2146HSPCP0000000795

    Murff, Ronald E MD*Clinton Family Physician1320 Old Weisgarber RoadKnoxville, TN 37909(865) 584-1054Language(s): FrenchHSPCP0000000795Robinson, Charles DOClinton Family Physician1300 Old Weisgarber RoadKnoxville, TN 37909(865) 584-2146Language(s): SpanishHSPCP0000000344Robinson, Charles DO*Clinton Family Physician1320 Old Weisgarber RoadBldg A Suite 202Knoxville, TN 37909(865) 584-1054Language(s): SpanishHSPCP0000000344Tarr, Jack H MD*Clinton Family Physician1300 Old Weisgarber RoadKnoxville, TN 37909(865) 584-2146QMP000003781453Tarr, Jack H MD*Clinton Family Physician1320 Old Weisgarber RoadKnoxville, TN 37909(865) 584-1054QMP000003781453Warren, Caleb T MD*Clinton Family Physician3403 Tazewell PikeSuite 102Knoxville, TN 37918(865) 689-9966HSPCP0000003992Internal Medicine / Medicina

    InternaAlley, James S MD*Clinton Family Physician6600 Nightingale LaneKnoxville, TN 37909(865) 632-5885QMP000003774030

    Alley, James S MD*Clinton Family Physician7564 Mountain Grove DriveKnoxville, TN 37920(865) 632-5885QMP000003774030Becker, Stephanie S MDClinton Family Physician9330 Park West BlvdSuite 402Knoxville, TN 37923(865) 690-3003QMP000003938181Bernard, Michael P MD*Clinton Family Physician7564 Mountain Grove DriveKnoxville, TN 37920(865) 632-5885HSPCP0000004063Bernard, Michael P MD*Clinton Family Physician6600 Nightingale LaneKnoxville, TN 37909(865) 632-5885HSPCP0000004063Boruff, Jeffrey S MDClinton Family Physician9330 Park West BlvdSuite 402Knoxville, TN 37923(865) 690-3003QMP000003674402Etezadi-Amoli, Saeed MD*Clinton Family Physician6600 Nightingale LaneKnoxville, TN 37909(865) 632-5885QMP000003660745Etezadi-Amoli, Saeed MD*Clinton Family Physician7564 Mountain Grove DriveKnoxville, TN 37920(865) 632-5885QMP000003660745

    Gallian, Richard S MD*Gallian Medical PLLC10744 Hardin Valley RoadSuite 106Knoxville, TN 37932(865) 383-7223HSSPC0000006821Goins, Andrew D MD*Clinton Family Physician9330 Park West BlvdSuite 402Knoxville, TN 37923(865) 690-3003QMP000004303364John, Sunil M MD*Clinton Family Physician6600 Nightingale LaneKnoxville, TN 37909(865) 632-5885QMP000003533187John, Sunil M MD*Clinton Family Physician7564 Mountain Grove DriveKnoxville, TN 37920(865) 632-5885QMP000003533187Marlow, Douglas J MDClinton Family Physician6600 Nightingale LnKnoxville, TN 37909(865) 632-5885QMP000003540146Marlow, Douglas J MDClinton Family Physician7564 Mountain Grove DrKnoxville, TN 37920(865) 632-5885QMP000003540146Rader, Karen T MDClinton Family Physician9330 Park West BlvdSuite 402Knoxville, TN 37923(865) 690-3003QMP000004214928

    Knoxville CovenantPrimary Care Providers (PCP) / Proveedores de atencin primaria (PCP)

    2 *Accepts Medicare and Medicaid Accepting Existing Patients Only Not Accepting New Patients*Acepta Medicare y Medicaid Acepta pacientes actuales solamente No acepta pacientes nuevos

  • Knox (cont.)Internal Medicine / Medicina

    Interna (cont.)Solomon, Marianne K MDClinton Family Physician9330 Park West BlvdSuite 402Knoxville, TN 37923(865) 690-3003QMP000004215631Swilley, Jeffrey A MD*Clinton Family Physician7564 Mountain Grove DriveKnoxville, TN 37920(865) 632-5885QMP000003757610Swilley, Jeffrey A MD*Clinton Family Physician6600 Nightingale LaneKnoxville, TN 37909(865) 632-5885QMP000003757610Thompson II, Robert G MD*Clinton Family Physician6600 Nightingale LaneKnoxville, TN 37909(865) 632-5885QMP000003582375Thompson II, Robert G MD*Clinton Family Physician7564 Mountain Grove DriveKnoxville, TN 37920(865) 632-5885QMP000003582375

    LoudonFamily Medicine / Medicina

    FamiliarNavorska, David Reue DO*Clinton Family Physician423 Medical Park DriveSuite 600Lenoir City, TN 37772(865) 271-6650QMP000003825248

    Stanley III, Richard EdmundMD*Clinton Family Physician423 Medical Park DriveSuite 100Lenoir City, TN 37772(865) 271-6600HSPCP0000003007Stovall, Troy W DO*Clinton Family Physician423 Medical Park DriveSuite 100Lenoir City, TN 37772(865) 271-6600QMP000003921934Geriatric Medicine / Medicina

    GeritricaRahman, Mohammad RMD*Clinton Family Physician111 Clyde StreetLoudon, TN 37774(865) 458-1554QMP000003581067Internal Medicine / Medicina

    InternaPatel, Bipinchandra M MD*Clinton Family Physician111 Clyde StreetLoudon, TN 37774(865) 458-1554QMP000003791387Premji, Moez R MD*Clinton Family Physician308 East Broadway StreetLenoir City, TN 37771(865) 988-5774HSPCP0000000100

    RoaneFamily Medicine / Medicina

    FamiliarLaymance, Jonathan B MDRoane County Family Practice1855 Tanner WaySuite 200Harriman, TN 37748(865) 376-6272HSVEN0000036082

    McMillin, Rodney MooreMD*Roane County Family Practice1855 Tanner WaySuite 200Harriman, TN 37748(865) 376-62726062273Tedder, Miriam B MD*Clinton Family Physician525 Devonia StreetSuite AHarriman, TN 37748(865) 882-5701HSPCP0000003500Wilson, Robert J MD*Roane County Family Practice1855 Tanner WaySuite 200Harriman, TN 37748(865) 376-6272HSPCP0000001341

    General Practice / PrcticaGeneral

    Willett, Dwight H MD*Kingston Family Practice820 W Race StreetKingston, TN 37763(865) 376-3406QMP000003547248Internal Medicine / Medicina

    InternaBelitz IV, John Conrad MD*Roane County Family Practice1855 Tanner WaySuite 200Harriman, TN 37748(865) 376-6272HSPCP0000004967Denton Jr, Randy L MD*Roane County FamilyMedicine1855 Tanner WaySuite 200Harriman, TN 37748(865) 376-6272HSPCP0000002457

    Iqbal, Farzana S MDKingston Family Practice820 West Race StreetKingston, TN 37763(865) 376-3406QMP000003559473

    SevierFamily Medicine / Medicina

    FamiliarHall, Steven F MD*Clinton Family Physician11546 Chapman HwySuite BSeymour, TN 37865(865) 579-5080QMP000003731289Internal Medicine / Medicina

    InternaBurton, Caroline McCarvillMDClinton Family Physician744 Middle Creek RoadSuite 108Sevierville, TN 37862(865) 446-9500QMP000003999683Vastine, David A MD*Clinton Family Physician744 Middle Creek RoadSuite 108Sevierville, TN 37862(865) 446-9500HSPCP0000002743Vastine, David A MD*Clinton Family Physician717 Middle Creek RoadSevierville, TN 37862(865) 366-4554HSPCP0000002743

    Knoxville CovenantPrimary Care Providers (PCP) / Proveedores de atencin primaria (PCP)

    3*Accepts Medicare and Medicaid Accepting Existing Patients Only Not Accepting New Patients*Acepta Medicare y Medicaid Acepta pacientes actuales solamente No acepta pacientes nuevos

  • Independent Provider / Losproveedores independientes

    AndersonPrimary Care Providers(PCP) / Proveedores deatencin primaria (PCP)

    Family Medicine / MedicinaFamiliar

    Webb, Brent A MD*Howard G, Holmes InternalMedicine151 Frank L Diggs DriveClinton, TN 37716(865) 647-3490QMP000003609803Webb, Brent A MD*Howard G, Holmes InternalMedicine7323 Chapman HwySuite 170Knoxville, TN 37920(865) 647-3900QMP000003609803

    BlountFamily Medicine / Medicina

    FamiliarCobb, Diana L*Cole Neuroscience Center281 Cusick RoadAlcoa, TN 37701(865) 970-0025QMP000003468876Deets, Cheryl L DOCole Neuroscience Center281 Cusick RoadAlcoa, TN 37701-3127(865) 970-0025HSPCP0000003528Internal Medicine / Medicina

    InternaCox, David A MD*Summit Medical Group1131 East Lamar AlexanderPkwyMaryville, TN 37804(865) 982-0170HSPCP0000000220

    Mendez, Eduardo R*Cole Neuroscience Center281 Cusick RoadAlcoa, TN 37701(865) 980-9721QMP000003624320Reyes, Susan A MD*SR Medical Services2602 US Hwy 411SMaryville, TN 37801(865) 238-9045HSSPC0000048264Semeco Rojas, Cristina E*Cole Neuroscience Center281 Cusick RoadAlcoa, TN 37701(865) 980-9721QMP000004330242

    Primary Care Clinic /Clnicas De Atencin

    GeneralCherokee Health Systems*Cherokee Health Systems255 East Watt StreetAlcoa, TN 37701(865) 273-1616HSPCP0000002342Cherokee Health Systems*Cherokee Health Systems255 East Watt StreetAlcoa, TN 37701(865) 273-1616HSPCP0000004036

    CampbellFamily Medicine / Medicina

    FamiliarStaudenmaier, Lori P*Cole Neuroscience Center109 Independence LaneSuite 300La Follette, TN 37766(423) 566-0958QMP000004336428

    Federally Qualified HealthCenter / Centro de SaludCalificado Federalmente

    Community Health of EastTennessee Inc*130 Independence LaneLa Follette, TN 37766(423) 562-1705Language(s): ArabicHSVEN0000013301

    Internal MedicineBaker Jr, Charles T*Cole Neuroscience Center109 Independence LaneSuite 200La Follette, TN 37766(423) 562-4968QMP000003779289Farris, James C*Cole Neuroscience Center109 Independence LaneSuite 200La Follette, TN 37766(423) 562-4968QMP000003732070Isber, Jamal MD*Internal and PulmonaryMedicine of LaFollette412 East Central AvenueLa Follette, TN 37766(423) 566-4142QMP000003603271Mansour, Elie MD*919 East Central AvenueSuite 103La Follette, TN 37766(423) 562-4976QMP000003525249Narula, Gurpteet K MD*LaFollette Health Clinic2503 Jacksboro PikeJacksboro, TN 37757(423) 566-6466QMP000003543201Narula, Harjeet S MD*LaFollette Health Clinic2503 Jacksboro PikeJacksboro, TN 37757(423) 566-6466QMP000003532470

    Oculam, Aleona A*Cole Neuroscience Center109 Independence LaneSuite 200La Follette, TN 37766(423) 562-4968QMP000003543823Subanithya, Dhamothara MDCampbell County HMA3170 Appalachian HwySuite 5Jacksboro, TN 37757(423) 907-1700QMP000004206875Terzian, Christian MDCampbell County HMA905 East Central AvenueLa Follette, TN 37766(423) 907-1600QMP000003687060Terzian, Christian MDCampbell County HMA2145 Jacksboro PikeLa Follette, TN 37766(423) 907-1700QMP000003687060

    Wound Care Specialist /Medicina Familiar

    Hutchings, Heather McCoyMDHealogics Specialty PhysiciansOf Tennessee PLLC923 East Central AvenueLaFollette, TN 37766(423) 907-1200QMP000004224686

    ClaiborneFamily Medicine / Medicina

    FamiliarLivesay, Tom D*Livesay Family Medicine, PC1610 Tazewell RoadSuite 203Tazewell, TN 37879(423) 626-6260QMP000003734740

    Independent Provider / Los proveedores independientesPrimary Care Providers (PCP) / Proveedores de atencin primaria (PCP)

    4 *Accepts Medicare and Medicaid Accepting Existing Patients Only Not Accepting New Patients*Acepta Medicare y Medicaid Acepta pacientes actuales solamente No acepta pacientes nuevos

  • Claiborne (cont.)Family Medicine / Medicina

    Familiar (cont.)Shields, Nicole P*University Medical Clinic165 Westmoreland StreetHarrogate, TN 37752(423) 869-7193QMP000004336405Yonts, Roy Christopher*University Medical Clinic165 Westmoreland StreetHarrogate, TN 37752(423) 869-7193QMP000003682900Zieren, Jan D*University Medical Clinic165 Westmoreland StreetHarrogate, TN 37752(423) 869-7193QMP000003500344

    Internal MedicineGreenstein, Allison BUniversity Medical Clinic165 Westmoreland StreetHarrogate, TN 37752(423) 869-7193QMP000004336440

    Primary Care Clinic /Clnicas De Atencin

    GeneralCherokee Health Systems*Cherokee Health Systems1596 Highway 33 SouthNew Tazewell, TN 37825(423) 626-8271HSPCP0000004036

    CockeFamily Medicine / Medicina

    FamiliarByrd, Leann M MD*Summit Medical Group610 Cosby HwyNewport, TN 37821-3414(423) 625-7777QMP000003640260

    Garbarino, Angelo J MD*Healthstar Physicians PC407 4th StreetNewport, TN 37821(423) 623-6240HSPCP0000004918Harricharan Singh, Kabir DDO*Healthstar Physicians PC407 4th StreetNewport, TN 37821(423) 623-6240QMP000004279963Harricharan Singh, RajkamalN MD*Healthstar Physicians PC407 4th StreetNewport, TN 37821(423) 623-6240QMP000004268407Hood, Michael T MD*Healthstar Physicians PC407 4th StreetNewport, TN 37821(423) 623-6240HSPCP0000002792Kickliter, David MDHealthstar Physicians PC407 4th StreetNewport, TN 37821(423) 623-6240QMP000003631044Manley, Emmett S MD*Summit Medical Group610 Cosby HwyNewport, TN 37821-3414(423) 625-7777QMP000003626341McConnell, David H MDHealthstar Physicians PC407 4th StreetNewport, TN 37821(423) 623-6240HSPCP0000002006Spiker, Catherine L MDHealthstar Physicians PC407 4th StreetNewport, TN 37821(423) 623-6240QMP000004271842

    Internal Medicine / MedicinaInterna

    Carter, Richard B MD*Summit Medical Group610 Cosby HwyNewport, TN 37821-3414(423) 625-7777HSPCP0000001174Cooley, Melissa A MD*Summit Medical Group610 Cosby HwyNewport, TN 37821-3414(423) 625-7777QMP000003812248Daniel, Anton ChristopherMD*Newport Internal Medicine235 Murray DriveNewport, TN 37821(423) 623-0601QMP000003801681Kirby, John A MD*Summit Medical Group610 Cosby HwyNewport, TN 37821-3414(423) 625-7777QMP000003612431Patton, Lance S MD*Summit Medical Group610 Cosby HwyNewport, TN 37821-3414(423) 625-7777QMP000003598616Ramsey, Bill W MD*Summit Medical Group610 Cosby HwyNewport, TN 37821-3414(423) 625-7777QMP000003729567Worley, Clyde W MD*Summit Medical Group610 Cosby HwyNewport, TN 37821-3414(423) 625-7777QMP000003547661

    CookeInternal Medicine / Medicina

    InternaDelay, Eric G MDHealthstar Physicians PC407 4th StreetNewport, TN 37821(423) 623-6240QMP000003689856

    CumberlandGeneral Practice / Prctica

    GeneralWallner, Jill M MD*58 West 1st StreetCrossville, TN 38555(931) 456-7992QMP000003679908Internal Medicine / Medicina

    InternaKouser, Hina S MD*Covenant Medical Group Inc421 South Main StreetCrossville, TN 38555(931) 459-7249QMP000003533946Stubbs, Maria V MDStubbs Medical Center189 Lantana RdCrossville, TN 38555(931) 456-0881G48181Todd, William A DOCovenant Medical Group Inc133 Hayes StCrossville, TN 38555(931) 456-9434HSPCP0000005257

    GraingerInternal Medicine / Medicina

    InternaDuck, Dennis H MD8731 Rutledge PikeSuite 700Rutledge, TN 37861(865) 828-5595HSPCP0000005307

    Independent Provider / Los proveedores independientesPrimary Care Providers (PCP) / Proveedores de atencin primaria (PCP)

    5*Accepts Medicare and Medicaid Accepting Existing Patients Only Not Accepting New Patients*Acepta Medicare y Medicaid Acepta pacientes actuales solamente No acepta pacientes nuevos

  • Grainger (cont.)Primary Care Clinic /Clnicas De Atencin

    GeneralCherokee Health Systems*Cherokee Health Systems180 Emory RoadBlaine, TN 37709(865) 933-4300HSPCP0000002342Cherokee Health Systems*Cherokee Health Systems1285 Highway 11 WestBean Station, TN 37708(865) 993-4300HSPCP0000002342Cherokee Health Systems*Cherokee Health Systems7719 Highway 131Washburn, TN 37888(865) 497-2591HSPCP0000002342Cherokee Health Systems*Cherokee Health Systems1285 Highway 11 WestBean Station, TN 37708(865) 993-4300HSPCP0000004036Cherokee Health Systems*Cherokee Health Systems180 Emory RoadBlaine, TN 37709(865) 933-4110HSPCP0000004036Cherokee Health Systems*Cherokee Health Systems7719 Highway 131Washburn, TN 37888(865) 497-2591HSPCP0000004036

    GreeneFamily Medicine / Medicina

    FamiliarOakley, Jamie G MD*Summit Medical Group1404 Tusculum BlvdLaughlin MOB #3 Suite 2300Greeneville, TN 37745(423) 639-2161HSPCP0000001914Schmalzried, Craig D MD*Summit Medical Group1404 Tusculum BlvdLaughlin MOB#3 Suite 2300Greeneville, TN 37745(423) 639-2161QMP000003607845

    HamblenFamily Medicine / Medicina

    FamiliarBunsic, Jana G MD*Healthstar Physicians PC420 West Morris BlvdSuite 400GMorristown, TN 37813-2282(423) 581-2538HSVEN0000001517Bunsic, Jana G MD*Healthstar Physicians PC1907 West Morris BlvdSuite EMorristown, TN 37813-2282(423) 318-8610HSVEN0000001517Burnette- Vick, BonnieAldine MDHealthstar Physicians PC420 West Morris BlvdSuite 400 BMorristown, TN 37813(423) 581-1026QMP000003740401Byrd, Leann M MD*Summit Medical Group1907 West Morris BlvdSuite A200Morristown, TN 37813(423) 625-7777QMP000003640260

    Dillard, Donna Rose MDHealthstar Physicians PC420 West Morris BlvdSuite 400BMorristown, TN 37813(423) 586-2410HSPCP0000000011Gupta, Rajeev MD*Primary Care And GeriatricsPC711 McFarland StreetMorristown, TN 37814(423) 317-7412QMP000003546511Hancock, Shannon P MD*Healthstar Physicians PC5741 West Andrew JohnsonHwyMorristown, TN 37814(423) 586-1717HSPCP0000001556Hancock, Shannon P MD*Healthstar Physicians PC420 West Morris BlvdSuite 400BMorristown, TN 37813(423) 586-2410HSPCP0000001556Manley, Emmett S MD*Summit Medical Group1907 West Morris BlvdSuite A200Morristown, TN 37813(423) 625-7777QMP000003626341McNabney, David P MDHealthstar Physicians PC420 West Morris BlvdSuite 400BMorristown, TN 37813(423) 586-2410QMP000003641395Melling, Blake P MDHealthstar Physicians PC5741 West Andrew JohnsonHwyMorristown, TN 37814(423) 586-1717QMP000003789632

    Melling, Blake P MD*Healthstar Physicians PC420 West Morris BlvdSuite 400BMorristown, TN 37813(423) 586-2410QMP000003789632Moncrief, Drew R DOHealthstar Physicians PC420 West Morris BlvdSuite 400BMorristown, TN 37813(423) 586-2410QMP000004118351Swanson, Rual Clark MD*Healthstar Physicians PC420 West Morris BlvdSuite 400BMorristown, TN 37813(423) 586-2410QMP000003578739Yarid, Frederick R MD*Hamblen Family Medicine823 McFarland StreetMorristown, TN 37914(423) 587-9777QMP000003713136

    General Practice / PrcticaGeneral

    Cooze, Derek A MD*Healthstar Physicians PC420 West Morris BlvdSuite 400BMorristown, TN 37813(423) 581-1026QMP000003533688Sutherland, Peter MichaelMD*Healthstar Physicians PC420 West Morris BlvdSuite 400BMorristown, TN 37813(423) 581-1026QMP000003616399

    Independent Provider / Los proveedores independientesPrimary Care Providers (PCP) / Proveedores de atencin primaria (PCP)

    6 *Accepts Medicare and Medicaid Accepting Existing Patients Only Not Accepting New Patients*Acepta Medicare y Medicaid Acepta pacientes actuales solamente No acepta pacientes nuevos

  • Hamblen (cont.)Internal Medicine / Medicina

    InternaCardali, Paul B MD*Healthstar Physicians PC420 West Morris BlvdSuite 400BMorristown, TN 37813(423) 586-0443QMP000003634876Carter, Richard B MD*Summit Medical Group1907 West Morris BlvdSuite A200Morristown, TN 37813(423) 625-7777HSPCP0000001174Cooley, Melissa A MD*Summit Medical Group1907 West Morris BlvdSuite A-200Morristown, TN 37813(423) 625-7777QMP000003812248Delay, Eric G MDHealthstar Physicians PC420 West Morris BlvdSuite 400 GMorristown, TN 37813-2282(423) 581-2538QMP000003689856Delay, Eric G MDHealthstar Physicians PC5741 West Andrew JohnsonHwyMorristown, TN 37813(865) 475-9857QMP000003689856Delay, Eric G MDHealthstar Physicians PC420 West Morris BlvdSuite BMorristown, TN 37813(423) 581-2538QMP000003689856

    Kirby, John A MD*Summit Medical Group1907 West Morris BlvdSuite A200Morristown, TN 37813(423) 625-7777QMP000003612431Patton, Lance S MD*Summit Medical Group1907 West Morris BlvdSuite A200Morristown, TN 37813(865) 475-4742QMP000003598616Ramsey, Bill W MD*Summit Medical Group1907 West Morris BlvdSuite A200Morristown, TN 37813(423) 625-7777QMP000003729567Worley, Clyde W MD*Summit Medical Group1907 West Morris BlvdSuite A200Morristown, TN 37813(423) 625-7777QMP000003547661

    Primary Care Clinic /Clnicas De Atencin

    GeneralCherokee Health Systems*Cherokee Health Systems815 West 5th North StreetMorristown, TN 37814(423) 586-5032HSPCP0000002342Cherokee Health Systems*Cherokee Health Systems6350 West Andrew JohnsonHwyTalbott, TN 37877(423) 587-7337HSPCP0000004036Cherokee Health Systems*Cherokee Health Systems6350 West A J HwyTalbott, TN 37877(423) 626-8271HSPCP0000004036

    Cherokee Health Systems*Cherokee Health Systems815 West 5th North StreetMorristown, TN 37814(423) 586-5032HSPCP0000004036

    HawkinsFamily Medicine / Medicina

    FamiliarOakley, Jamie G MD*Summit Medical Group3353 Hwy 11 WestSurgoinsville, TN 37873(423) 639-2161HSPCP0000001914Schmalzried, Craig D MD*Summit Medical Group3353 Highway 11 WestSurgoinsville, TN 37873(423) 639-2161QMP000003607845

    JeffersonFamily Medicine / Medicina

    FamiliarByrd, Leann M MD*Summit Medical Group120 Hospital DriveSuite 130Jefferson City, TN 37760-5279(615) 475-4742QMP000003640260Darby, Dewayne PaschallMD*Healthstar Physicians PC150 W Price RdDandridge, TN 37725(865) 475-6161QMP000003554790Dillard, Donna Rose MDHealthstar Physicians PC150 West Price RoadDandridge, TN 37725(865) 475-6161HSPCP0000000011

    Harricharan Singh, Kabir DDOHealthstar Physicians PC1403 State StreetWhite Pine, TN 37890(865) 674-6603QMP000004279963Harricharan Singh, RajkamalN MD*Healthstar Physicians PC1403 State StreetWhite Pine, TN 37890(865) 674-6603QMP000004268407Hood, Michael T MD*Healthstar Physicians PC1403 State StreetSuite 310White PIne, TN 37890(865) 674-6603HSPCP0000002792Kickliter, David MDHealthstar Physicians PC1403 State StreetSuite 310White Pine, TN 37890(865) 674-6603QMP000003631044Manley, Emmett S MD*Summit Medical Group120 Hospital DriveSuite 130Jefferson City, TN 37760-5279(865) 475-4742QMP000003626341McConnell, David H MDHealthstar Physicians PC1403 State StreetWhite Pine, TN 37890(865) 674-6603HSPCP0000002006McNabney, David P MDHealthstar Physicians PC150 West Price RoadDandridge, TN 37725(865) 475-6161QMP000003641395

    Independent Provider / Los proveedores independientesPrimary Care Providers (PCP) / Proveedores de atencin primaria (PCP)

    7*Accepts Medicare and Medicaid Accepting Existing Patients Only Not Accepting New Patients*Acepta Medicare y Medicaid Acepta pacientes actuales solamente No acepta pacientes nuevos

  • Jefferson (cont.)Family Medicine / Medicina

    Familiar (cont.)Moncrief, Drew R DOHealthstar Physicians PC150 West Price RoadDandridge, TN 37725(865) 475-6161QMP000004118351Purdom, Laura D MDHealthstar Physicians PC150 Wwst Price RoadDandridge, TN 37725(865) 475-6161QMP000003815150Spiker, Catherine L MDHealthstar Physicians PC1403 State StreetWhite Pine, TN 37890(865) 674-6603QMP000004271842Swanson, Rual Clark MD*Healthstar Physicians PC150 West Price RoadDandridge, TN 37725(865) 475-6161QMP000003578739Witherspoon, Nancy L DO*Healthstar Physicians PC150 W Price RdDandridge, TN 37725(865) 475-61616062778Internal Medicine / Medicina

    InternaCarter, Richard B MD*Summit Medical Group120 Hospital DriveSuite 130Jefferson City, TN 37760-5279(865) 475-4742HSPCP0000001174Cooley, Melissa A MD*Summit Medical Group120 Hospital DriveSuite 130Jefferson City, TN 37760-5279(865) 475-4742QMP000003812248

    Damron, Douglas L*Cole Neuroscience Center1413 Russell AvenueJefferson City, TN 37760(865) 475-1177QMP000003957981Delay, Eric G MDHealthstar Physicians PC657 East BroadwaySuite CJefferson City, TN 37760(865) 375-6005QMP000003689856Delay, Eric G MDHealthstar Physicians PC150 West Price RoadDandridge, TN 37725(865) 475-6161QMP000003689856Delay, Eric G MDHealthstar Physicians PC1403 State StreetWhite Pine, TN 37890(865) 674-6603QMP000003689856Kirby, John A MD*Summit Medical Group120 Hospital DriveSuite 130Jefferson City, TN 37760-5279(865) 475-4742QMP000003612431Kouser, Hina S MD*Healt