Individual
JACK MONROE VISCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
49 CLEVELAND ST STE 350, CROSSVILLE, TN 38555-2898
(931) 459-7720
Mailing address
7331 CRESTHILL DR APT E5, KNOXVILLE, TN 37919-5918
(901) 606-9357
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
7121
TN
363AS0400X
Surgical Physician Assistant
Primary
7121
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q112201
—
TN
Enumeration date
04/08/2026
Last updated
05/04/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us