Individual provider Active NPI

Anthony Shane McRaven, D.O.

  • Internal Medicine Physician
  • Knoxville, TN
National Provider Identifier
1114298916
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2405 Issued in TN
Practice address
1431 Centerpoint Blvd
Suite 100
Knoxville, TN 37932-1984
Phone
(800) 342-2898
NPI assigned
Jan 25, 2012
Last updated
Oct 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2405 TN
Internal Medicine Physician 207R00000X 2405 TN Primary
Internal Medicine Physician 207R00000X 22204 MS

Addresses

Primary practice location

1431 Centerpoint Blvd
Suite 100
Knoxville, TN 37932-1984

Mailing address

1431 Centerpoint Blvd
Suite 100
Knoxville, TN 37932-1984

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140731001053 TN Practitioner - Internal MedicinePractitioner - Emergency Medicine 7618126137 Reassigns benefits to 2 organizations
I20200528001657 NJ Practitioner - Internal Medicine 7618126137 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2405TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jul 15, 2015 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Jun 1, 2015 Accepting new patients
Hospitalist Physicians of New Jersey PA Internal Medicine CurrentSince Apr 1, 2020 Accepting new patients
Alliance Healthcare System, Inc Past Accepting new patients
Deep South Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Tishomingo Health Services, Inc. Past Accepting new patients

Locations

65 James St
Edison, NJ 08820
Phone (732) 321-7010

727 N Beers St
Holmdel, NJ 07733
Phone (732) 714-2700

1431 Centerpoint Blvd
Ste 100
Knoxville, TN 37932
Phone (865) 539-8000

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/allihcs-9d312177

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1114298916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 CENTERPOINT BLVD",
            "address_2": "SUITE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 CENTERPOINT BLVD",
            "address_2": "SUITE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321984",
            "telephone_number": "800-342-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCRAVEN",
        "first_name": "ANTHONY",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-25",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "2405",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "2405",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "22204",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.