Individual provider Active NPI

Corey Deuso, D.O.

  • Internal Medicine Physician
  • Knoxville, TN
National Provider Identifier
1104209980
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
3546 Issued in TN
Practice address
1900 N Winston Rd Ste 501
Knoxville, TN 37919-3605
Phone
(865) 909-0090
NPI assigned
Jun 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3546 TN Primary

Addresses

Primary practice location

1900 N Winston Rd Ste 501
Knoxville, TN 37919-3605

Mailing address

1900 N Winston Rd Ste 501
Knoxville, TN 37919-3605
Phone (865) 909-0090

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181010002740 TN Practitioner - Internal Medicine 4385940147

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lincoln Memorial University Medical Department, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6821 Shadow Creek Rd
Knoxville, TN 37918-9541

7725 W Reno Ave
Suite 330
Oklahoma City, OK 73127-9742

Hospital & facility affiliations

  • Covenant Homecare Home health agency, Knoxville, TN, CCN 447139
  • Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173
  • Fort Loudoun Medical Center Hospital, Lenoir City, TN, CCN 440110
  • Cumberland Medical Center Hospital, Crossville, TN, CCN 440009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3546TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Statcare Inpatient LLC Internal Medicine CurrentSince Sep 1, 2018 Accepting new patients

Locations

1901 Clinch Ave
Knoxville, TN 37916
Phone (865) 331-1111

1900 N Winston Rd
Ste 501
Knoxville, TN 37919
Phone (865) 909-0090

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 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": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1104209980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 N WINSTON RD STE 501",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379193605",
            "telephone_number": "865-909-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N WINSTON RD STE 501",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379193605",
            "telephone_number": "865-909-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEUSO",
        "first_name": "COREY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-30",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "3546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.