Ahmed Kassem Selim Abdallah, M.D

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

73872 Issued in TN

Practice address

689 Medical Park Dr Ste 301
Lenoir City, TN 37772-5798

Phone

(865) 988-9970

Fax

(865) 271-6621

NPI assigned

Apr 11, 2018

Reactivated

Dec 5, 2018

Last updated

Jun 24, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fort Loudoun Medical CenterGroup PAC ID 3476451063, 3 clinicians

Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fort Loudoun Medical Center Hospital, Lenoir City, TN, CCN 440110
• Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abdallah.ahmed.kassem@covenanthealth.cernerdirect.com

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.

• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Fort Loudoun Medical Center

  • General Acute Care Hospital
  • Lenoir City, TN
  • NPI 1609860659
  Medicare reassignment Care Compare group NPD
• Covenant Medical Group, Inc

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

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fort Loudoun Medical Center

  • General Acute Care Hospital
  • Lenoir City, TN
  • NPI 1609860659
  Care Compare affiliation
• Parkwest Medical Center

  dba Peninsula Div Parkwest MC

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1396739165
  Care Compare affiliation

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1124525597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "689 MEDICAL PARK DR STE 301",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377725798",
            "telephone_number": "865-988-9970",
            "fax_number": "865-271-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "689 MEDICAL PARK DR STE 301",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377725798",
            "telephone_number": "865-988-9970",
            "fax_number": "865-271-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDALLAH",
        "first_name": "AHMED",
        "middle_name": "KASSEM SELIM",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-11",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "deactivation_date": "2018-11-28",
        "reactivation_date": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "73872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q067579",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abdallah.ahmed.kassem@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "689 Medical Park Dr Ste 301",
            "city": "Lenoir City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377725798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• A Healthy Life Chiropractic
• ABA Next Steps
• Wahid John Abadier, MD
• Bassem A Abazid, M.D.
• Maged Yousif Abdu, P.T.
• Marie Ellen Abdu, COTA/L
• Walter Adams
• Scott L Adkisson
• Adult Community Training Inc.

• Cardiovascular Disease Physician in Lenoir City, TN
• Providers in Lenoir City, TN by specialty
• Cardiovascular Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.