NPIMap

Individual provider Active NPI

Sudarshan R Doddabele, MD

  • Hematology & Oncology Physician
  • Knoxville, TN
National Provider Identifier
1144332495
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
31484 Issued in TN
Practice address
1415 Old Weisgarber Rd Ste 200
Knoxville, TN 37909-1341
Phone
(865) 934-5800
Fax
(865) 934-5801
NPI assigned
Aug 31, 2006
Last updated
Apr 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 48401 KY
Hematology & Oncology Physician 207RH0003X 31484 TN Primary

Addresses

Primary practice location

1415 Old Weisgarber Rd Ste 200
Knoxville, TN 37909-1341

Mailing address

900 E Hill Ave Ste 230
Knoxville, TN 37915-2565
Phone (865) 862-0998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051003000599 TN Practitioner - Hematology/OncologyPractitioner - Internal Medicine 3779518386 Reassigns benefits to 1 organization
I20150826002248 KY Practitioner - Hematology/Oncology 3779518386

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1301 Sunset Dr
Suite 3
Johnson City, TN 37604-7906
Phone (423) 588-7130

380 W Broadway Blvd
Jefferson City, TN 37760-2602
Phone (865) 934-5800

389 Forge Ridge Rd
Harrogate, TN 37752-7730
Phone (423) 869-5893

900 E Hill Ave
Suite 230
Knoxville, TN 37915-2565
Phone (865) 862-0998

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48401KYMDHematology & Oncology Physician
31484TNMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Cancer Specialists PLLC Hematology & Oncology CurrentSince Sep 2, 2014 Accepting new patients
Tennessee Cancer Specialists PLLC Hematology & Oncology Past Accepting new patients
Cresent Medical, PLLC Past Accepting new patients

Locations

6016 Brookvale Ln
Ste 200
Knoxville, TN 37919
Phone (865) 862-0998

900 E Hill Ave
Ste 230
Knoxville, TN 37915
Phone (865) 862-0998

Interoperability endpoints

  • Direct secure messaging: sudarshan.doddabele@tncancer.direct.varian.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1144332495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E HILL AVE STE 230",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379152565",
            "telephone_number": "865-862-0998",
            "fax_number": "865-544-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 OLD WEISGARBER RD STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091341",
            "telephone_number": "865-934-5800",
            "fax_number": "865-934-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODDABELE",
        "first_name": "SUDARSHAN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "KY",
            "license": "48401",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TN",
            "license": "31484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.