VIVID PATH LLC
NPI 1356136501
Nurse Practitioner - Psychiatric/Mental Health in Knoxville, TN
About Vivid Path Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VIVID PATH LLC (NPI 1356136501) is a healthcare organization registered as a psychiatric/mental health in Knoxville, Tennessee and active in the NPI registry since April 2025. The organization lists Amber Jordan, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Vivid Path Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Vivid Path LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
Knoxville, TN 37923
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Vivid Path LLC's NPI number?
The NPI number for Vivid Path LLC is 1356136501. It was assigned to this organization in the NPPES registry on April 10, 2025.
Where is Vivid Path LLC located?
Vivid Path LLC is located at 9050 Executive Park Dr Ste 109A, Knoxville, TN 37923. The listed phone number is (865) 217-6080.
What is Vivid Path LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Vivid Path LLC enrolled in Medicare?
Yes. Vivid Path LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Vivid Path LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Vivid Path LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Vivid Path LLC was last updated on October 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Vivid Path Llc · NPI 1356136501
Psychiatric/Mental Health organization in Knoxville, Tennessee. Organization record, active in the CMS NPPES registry since April 10, 2025.
## Identity
- **NPI:** 1356136501 (Entity type: Organization)
- **Enumerated:** April 10, 2025
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Amber Jordan, OWNER
## Practice location
- **Address:** 9050 EXECUTIVE PARK DR STE 109A, Knoxville, TN 37923-4669
- **Phone:** (865) 217-6080
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 3, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1356136501) · Data from the CMS NPPES public registry.