NPIMap

Organization Active NPI

Covenant Health Diagnostic Centers, LLC

  • Physiological Laboratory
  • Knoxville, TN
National Provider Identifier
1255950895
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
COVENANT HEALTH DIAGNOSTIC CENTERS, LLC
Practice address
210 Fort Sanders West Blvd
BLDG 3, Suite 100
Knoxville, TN 37922-3353
Phone
(865) 531-5400
NPI assigned
Apr 14, 2020
Last updated
Jul 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Authorized official

Name
Monty Scott
Title
Cao
Phone
(865) 374-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X NU Primary

Addresses

Primary practice location

210 Fort Sanders West Blvd
BLDG 3, Suite 100
Knoxville, TN 37922-3353

Mailing address

1420 Centerpoint Blvd BLDG C
Knoxville, TN 37932-1960
Phone (865) 374-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220114001284 TN Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2961894357 Receives reassigned benefits from 15 practitioners
Practice locations: Knoxille, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2286564Covenant Health Diagnostics, LLC210 Fort Sanders West Blvd, BLDG 3, Suite 100, Knoxville, TN 37922Certificate of waiverJul 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
Covenant Health Diagnostic Centers2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

100 Fort Sanders West Blvd
Ste 100
Knoxville, TN 37922

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1255950895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 CENTERPOINT BLVD BLDG C",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321960",
            "telephone_number": "865-374-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 FORT SANDERS WEST BLVD",
            "address_2": "BLDG 3, SUITE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223353",
            "telephone_number": "865-531-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HEALTH DIAGNOSTIC CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-14",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "MONTY",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "865-374-5200"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.