Individual provider Active NPI

Robert Norman Page, MD

  • Dermatopathology (Pathology) Physician
  • Knoxville, TN
National Provider Identifier
1023016557
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
33969 Issued in TN
Practice address
139 Fox Rd
Ste 204
Knoxville, TN 37922-3472
Phone
(865) 474-8866
Fax
(865) 238-2626
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X 33969 TN Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01095024A IN
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X EMC0006597 MI

Addresses

Primary practice location

139 Fox Rd
Ste 204
Knoxville, TN 37922-3472

Mailing address

PO Box 440500
Nashville, TN 37244-0500
Phone (865) 670-6199

Other practice location 1

1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone (269) 226-7231

Other practice location 2

3355 Douglas Rd
South Bend, IN 46635-1779
Phone (574) 234-4176

Other identifiers 2

IdentifierTypeStateIssuer
3862687MedicaidTN
4325429OtherTNBCBS DERMATOPATHOLOGY PARTNERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MI, IN3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20100623000506 TN Practitioner - Pathology 9335177286 Reassigns benefits to 2 organizations
I20250725001455 MI Practitioner - Pathology 9335177286 Reassigns benefits to 2 organizations
I20250918002319 IN Practitioner - Pathology 9335177286 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Arkansas College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatopathology Partners PCGroup PAC ID 1951560739, 8 clinicians
South Bend Medical Foundation IncGroup PAC ID 3971411349, shared by 2 NPIs, 14 clinicians
Legacy Path LLCGroup PAC ID 5890237960, 16 clinicians

Practice addresses (Care Compare)

139 Fox Rd
Knoxville, TN 37922-3472

1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone (269) 266-7231

3355 Douglas Rd
South Bend, IN 46635-1779
Phone (574) 234-4176

Merit-based Incentive Payment System (MIPS)

Final score
45 of 100Reported as individual
Quality
90
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
EMC0006597MIMDAnatomic Pathology & Clinical Pathology Physician
33969TNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatopathology Partners PC Dermatopathology CurrentSince May 15, 2012 Accepting new patients
South Bend Medical Foundation, Inc Dermatopathology Current Accepting new patients
Legacy Path LLC Anatomic Pathology & Clinical Pathology CurrentSince Jun 1, 2025 Accepting new patients
South Bend Medical Foundation, Inc Anatomic Pathology & Clinical Pathology CurrentSince Jun 1, 2025 Accepting new patients
Outreach Clinics Unlimited PLLC Past Accepting new patients

Locations

3355 Douglas Rd
South Bend, IN 46635
Phone (574) 234-4176

530 N Lafayette Blvd
South Bend, IN 46601
Phone (574) 204-5206

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

5700 Southwyck Blvd
Toledo, OH 43614

Dept 888136
Knoxville, TN 37995

139 Fox Rd
Ste 204
Knoxville, TN 37922
Phone (865) 201-2560

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1023016557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 440500",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372440500",
            "telephone_number": "865-670-6199",
            "fax_number": "865-670-6188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 FOX RD",
            "address_2": "STE 204",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223472",
            "telephone_number": "865-474-8866",
            "fax_number": "865-238-2626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1521 Gull Rd",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490481640",
            "country_code": "US",
            "telephone_number": "269-226-7231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3355 Douglas Rd",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466351779",
            "country_code": "US",
            "telephone_number": "574-234-4176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAGE",
        "first_name": "ROBERT",
        "middle_name": "NORMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "TN",
            "license": "33969",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01095024A",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "EMC0006597",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3862687",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DERMATOPATHOLOGY PARTNERS",
            "identifier": "4325429",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.