Individual provider Active NPI

Michael Patrick Flynn, PA-C

  • Physician Assistant
  • Knoxville, TN
National Provider Identifier
1003275132
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2978 Issued in TN
Practice address
501 20TH St Ste 503
Knoxville, TN 37916-1832
Phone
(865) 331-4321
Fax
(865) 331-4320
NPI assigned
Feb 17, 2016
Last updated
Aug 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2978 TN Primary

Addresses

Primary practice location

501 20TH St Ste 503
Knoxville, TN 37916-1832

Mailing address

501 20TH St Ste 503
Knoxville, TN 37916-1832
Phone (865) 331-4321

Other practice location 1

930 E Emerald Ave
#511
Knoxville, TN 37917-4539
Phone (865) 647-3330

Other identifiers 1

IdentifierTypeStateIssuer
Q020113MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address flynn.michael.patrick@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160315001343 TN Practitioner - Physician Assistant 4183920382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

111 Clyde St
Loudon, TN 37774-1600
Phone (865) 458-1554

9352 Park W Blvd
Knoxville, TN 37923-4325
Phone (865) 373-1974

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2978TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. Physician Assistant CurrentSince May 14, 2018 Accepting new patients

Locations

501 20th St
Ste 503
Knoxville, TN 37916
Phone (865) 331-4321

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

Interoperability endpoints

  • Direct secure messaging: flynn.michael.patrick@covenanthealth.cernerdirect.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1003275132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 20TH ST STE 503",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161832",
            "telephone_number": "865-331-4321",
            "fax_number": "865-374-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 20TH ST STE 503",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161832",
            "telephone_number": "865-331-4321",
            "fax_number": "865-331-4320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 E Emerald Ave",
            "address_2": "#511",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379174539",
            "country_code": "US",
            "telephone_number": "865-647-3330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-17",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q020113",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "flynn.michael.patrick@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "501 20th St Ste 503",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379161832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.