Individual provider Active NPI

Brion B. Shin, M.D.

  • Radiation Oncology Physician
  • Knoxville, TN
National Provider Identifier
1184825283
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
62775 Issued in TN
Practice address
6450 Provision Cares Way
Knoxville, TN 37909-2544
Phone
(865) 862-1600
NPI assigned
May 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 01066928A IN
Radiation Oncology Physician 2085R0001X A94346 CA
Radiation Oncology Physician 2085R0001X 62775 TN Primary

Addresses

Primary practice location

6450 Provision Cares Way
Knoxville, TN 37909-2544

Mailing address

6450 Provision Cares Way
Knoxville, TN 37909-2544
Phone (865) 862-1600

Other identifiers 1

IdentifierTypeStateIssuer
Q069892MedicaidTN

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
I20211105001637 TN Practitioner - Radiation Oncology 6204988405 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Loma Linda University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thompson Oncology GroupGroup PAC ID 0941246771, 65 clinicians

Practice addresses (Care Compare)

1415 Old Weisgarber Rd
Suite 250
Knoxville, TN 37909-1327
Phone (865) 437-5252

6450 Provision Cares Way
Knoxville, TN 37909-2544
Phone (865) 862-1600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A94346CAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thompson Oncology Group Radiation Oncology CurrentSince Jul 18, 2022 Accepting new patients

Locations

6450 Provision Cares Way
Knoxville, TN 37909
Phone (865) 342-4518

Dept 888078
Knoxville, TN 37995

1915 White Ave
Knoxville, TN 37916
Phone (423) 977-1065

Organizations & group practices 2

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 1

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1184825283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6450 PROVISION CARES WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092544",
            "telephone_number": "865-862-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6450 PROVISION CARES WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092544",
            "telephone_number": "865-862-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "BRION",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IN",
            "license": "01066928A",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A94346",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TN",
            "license": "62775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q069892",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.