MAZIE BIVENS – Family Nurse Practitioner, NPI 1114809738

MAZIE BIVENS is a healthcare provider. based in Maryville, Tennessee. specializing in NURSE PRACTITIONER. They hold a License No. 38983 (TN). The NPI Number for MAZIE BIVENS is 1114809738

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
MAZIE BIVENS
NPI
1114809738
Phone
(423) 836-3560
Address
1759 GRAND PINE PT
Enumeration Date
24 July 2025
Last Update Date
14 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4234422622
Graduation Year
2025 (1 year ago)
PAC ID
9335643519
Group Practice PAC ID
9436130135
Professional Enrollment ID
I20250919001990
Address ID
TN373541287MA4798X68XX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness85
Years active:0State licenses:2Digital endpointsOther names

10,664 NURSE PRACTITIONER in TN

Provider Addresses for MAZIE BIVENS

  • 1759 GRAND PINE PT

    MARYVILLE, TN 378012403

    Phone: (423) 836-3560

    Type: Mailing

  • 4798 NEW HIGHWAY 68

    MADISONVILLE, TN 373541287

    Phone: (423) 442-2622

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250919001990INurse PractitionerTNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 37801)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9436130135View full group profile
NameSpecialtyState
Osteopathic Manipulative MedicineTN
Family PracticeTN
Nurse PractitionerTN
Nurse PractitionerTN
-TN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
-TN

Reviews

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Frequently asked questions

What number should I use to identify MAZIE BIVENS for billing?
Administrative and clinical systems typically use NPI 1114809738 for MAZIE BIVENS.
Is MAZIE BIVENS's NPI status active today?
Active status means MAZIE BIVENS's NPI record is not deactivated in the public file.
What services align with MAZIE BIVENS's listing?
MAZIE BIVENS's public classification highlights Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to MAZIE BIVENS?
The directory associates MAZIE BIVENS with Maryville, Tennessee. Check all listed addresses for suites or satellite offices.
Can I export MAZIE BIVENS's record?
You can download the official NPPES record; we summarize key fields for readability.

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