Covenant Medical Group, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

COVENANT MEDICAL GROUP, INC

Practice address

205 Corporate PL
Alcoa, TN 37701-1940

Phone

(865) 331-9050

Fax

(865) 374-2008

NPI assigned

Oct 8, 2020

Last updated

Nov 8, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Julie Utterback

Title

VP Financial Services

Phone

(865) 374-5119

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Covenant Medical Group, Inc

  • Urology Physician
  • Knoxville, TN
  • NPI 1386241859

  2860305463

  Same PAC ID
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1871269415

  2860305463

  Same PAC ID
• Covenant Medical Group, Inc

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1881636488

  2860305463

  Same PAC ID
• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010

  2860305463

  Same PAC ID

Tax ID family

Internal Medicince West a Member of Covenant Health5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Covenant Medical Group, Inc

  • Urology Physician
  • Knoxville, TN
  • NPI 1386241859
  NPD tax ID
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1871269415
  NPD tax ID
• Covenant Medical Group, Inc

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1881636488
  NPD tax ID
• Internal Medicince West a Member of Covenant Health

  • Internal Medicine Physician
  • Knoxville, TN
  • NPI 1922138262
  NPD tax ID

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1093312415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 CENTERPOINT BLVD STE 202",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379322146",
            "telephone_number": "865-374-5200",
            "fax_number": "865-374-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 CORPORATE PL",
            "city": "ALCOA",
            "state": "TN",
            "postal_code": "377011940",
            "telephone_number": "865-331-9050",
            "fax_number": "865-374-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "UTTERBACK",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "VP FINANCIAL SERVICES",
        "authorized_official_telephone_number": "865-374-5119"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tommy Collins, M.D.
• Cara C Connors, M.D.
• Cody Michael Cook
• Greg S Cook, D.D.S.
• Country Creek Dental PLLC
• Katherine Cox
• Jacob Crabtree, APRN
• Holly Crim, M.D.
• Danielle Marie Curtis, MS
• Katherine Kesler Dabbs, M.D.

• Durable Medical Equipment & Medical Supplies in Alcoa, TN
• Providers in Alcoa, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.