Individual provider Active NPI

Lia R. Odorisi, PA

  • Physician Assistant
  • Knoxville, TN
National Provider Identifier
1023712809
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5468 Issued in TN
Practice address
9320 Park West Blvd
Knoxville, TN 37923-4301
Phone
(865) 373-7100
NPI assigned
Mar 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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 5468 TN Primary

Addresses

Primary practice location

9320 Park West Blvd
Knoxville, TN 37923-4301

Mailing address

9320 Park West Blvd
Knoxville, TN 37923-4301
Phone (865) 373-7100

Other identifiers 1

IdentifierTypeStateIssuer
Q081814MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address odorisi.lia@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
I20230411000071 TN Practitioner - Physician Assistant 6002281847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Memorial University Medical Department, 2022
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

576 Fort Loudon Medical Ctr Dr
Lenoir City, TN 37772-5676

6600 Nightingale LN
Knoxville, TN 37909-2754
Phone (865) 632-5885

744 Middle Creek Rd
Sevierville, TN 37862-5036

9330 Park W Blvd
Suite 200
Knoxville, TN 37923-4310
Phone (865) 373-5100

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

Hospital & facility affiliations

  • Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173
  • Leconte Medical Center Hospital, Sevierville, TN, CCN 440081
  • Fort Loudoun Medical Center Hospital, Lenoir City, TN, CCN 440110
  • Roane Medical Center Hospital, Harriman, TN, CCN 440031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5468TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. Physician Assistant CurrentSince Mar 27, 2023 Accepting new patients
Covenant Medical Group, Inc CurrentSince Mar 27, 2023 Accepting new patients

Locations

9320 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-7100

Dept 888179
Knoxville, TN 37995

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

744 Middle Creek Rd
Ste 114
Sevierville, TN 37862
Phone (865) 446-9575

Interoperability endpoints

  • Direct secure messaging: odorisi.lia@covenanthealth.cernerdirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1023712809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9320 PARK WEST BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234301",
            "telephone_number": "865-373-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 PARK WEST BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234301",
            "telephone_number": "865-373-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODORISI",
        "first_name": "LIA",
        "middle_name": "R.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q081814",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "odorisi.lia@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "9320 Park West Blvd",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379234301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.