NPIMap

Organization Active NPI

Osteopathic Center PLLC

  • Sports Medicine (Family Medicine) Physician
  • Knoxville, TN
National Provider Identifier
1104236421
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
DO0000002081 Issued in TN
Legal business name
OSTEOPATHIC CENTER PLLC
Practice address
9000 Executive Park Dr
Suite A210
Knoxville, TN 37923-4685
Phone
(865) 321-1732
Fax
(865) 321-1733
NPI assigned
May 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Authorized official

Name
Kristopher JS Goddard, DONPI 1780910364
Title
Owner
Phone
(865) 321-1732

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QS0010X DO0000002081 TN Primary

Addresses

Primary practice location

9000 Executive Park Dr
Suite A210
Knoxville, TN 37923-4685

Mailing address

9000 Executive Park Dr
Suite A210
Knoxville, TN 37923-4685
Phone (865) 321-1732

National Provider Directory

National Provider Directory

Locations

9000 Executive Park Dr
Ste A210
Knoxville, TN 37923
Phone (865) 321-1732

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1104236421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 EXECUTIVE PARK DR",
            "address_2": "SUITE A210",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234685",
            "telephone_number": "865-321-1732",
            "fax_number": "865-321-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 EXECUTIVE PARK DR",
            "address_2": "SUITE A210",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234685",
            "telephone_number": "865-321-1732",
            "fax_number": "865-321-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSTEOPATHIC CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-08",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "GODDARD",
        "authorized_official_first_name": "KRISTOPHER",
        "authorized_official_middle_name": "JS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-321-1732",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TN",
            "license": "DO0000002081",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 25, 2016; 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.