Fredric M Radoff, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

19787 Issued in TN

Practice address

266 Joule St
Alcoa, TN 37701-2422

Phone

(865) 984-3864

Fax

(865) 380-4095

NPI assigned

Nov 2, 2006

Sex

Male

Sole proprietor

No

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.

• East Tennessee Medical Group, PC

  • Family Medicine Physician
  • Alcoa, TN
  • NPI 1942238902

  Neurology

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 1, 2017.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1255419388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W BROADWAY AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014703",
            "telephone_number": "865-273-1752",
            "fax_number": "865-273-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 JOULE ST",
            "city": "ALCOA",
            "state": "TN",
            "postal_code": "377012422",
            "telephone_number": "865-984-3864",
            "fax_number": "865-380-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADOFF",
        "first_name": "FREDRIC",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "19787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3045402",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ponce Fernandez
• Autumn Potter, PHARMD
• Eric Leigh Poulsen, M.ED
• Jenna Hope Poynter, CNA
• Jack W Raby, LDO
• Charles L Rahn, M.D.
• Erika Paige Ramsdale, PHARM.D.
• Benjamin Harmon Rasnick, D.C.
• Kaitlyn Elizabeth Reid, PT, DPT
• Mark A Reiff

• All providers in Alcoa, TN
• Neurology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; 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.