Individual provider Active NPI

Michael D Underwood, M.D.

  • Interventional Cardiology Physician
  • Knoxville, TN
National Provider Identifier
1053376236
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD8549 Issued in TN
Practice address
10810 Parkside Dr
Suite 201
Knoxville, TN 37934-1979
Phone
(865) 690-9475
Fax
(865) 690-2033
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD8549 TN
Interventional Cardiology Physician 207RI0011X MD8549 TN Primary

Addresses

Primary practice location

10810 Parkside Dr
Suite 201
Knoxville, TN 37934-1979

Mailing address

10810 Parkside Dr
Suite 201
Knoxville, TN 37934-1979
Phone (865) 690-9475

Other identifiers 1

IdentifierTypeStateIssuer
3170607MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6682/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1053376236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 PARKSIDE DR",
            "address_2": "SUITE 201",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379341979",
            "telephone_number": "865-690-9475",
            "fax_number": "865-690-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10810 PARKSIDE DR",
            "address_2": "SUITE 201",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379341979",
            "telephone_number": "865-690-9475",
            "fax_number": "865-690-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "MD8549",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TN",
            "license": "MD8549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3170607",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.