NPIMap

Organization Active NPI

Faculty Internal Medicine, PLLC

  • Specialist
  • Knoxville, TN
National Provider Identifier
1265457113
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
FACULTY INTERNAL MEDICINE, PLLC
Practice address
11440 Parkside Dr
Suite 302
Knoxville, TN 37934-2658
Phone
(865) 288-1548
Fax
(865) 377-1002
NPI assigned
Jul 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Daniel S. Ely, M.D.NPI 1194744516
Title
Managing Partner
Phone
(865) 288-1548

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X TN Primary

Addresses

Primary practice location

11440 Parkside Dr
Suite 302
Knoxville, TN 37934-2658

Mailing address

11440 Parkside Dr
Suite 302
Knoxville, TN 37934-2658
Phone (865) 288-1548

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031222000008 TN Part B Supplier - Clinic/Group Practice 4789582305 Receives reassigned benefits from 19 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Knoxville, TN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Faculty Internal Medicine3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

11440 Parkside Dr
Ste 302
Knoxville, TN 37934
Phone (865) 218-9220

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265457113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11440 PARKSIDE DR",
            "address_2": "SUITE 302",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379342658",
            "telephone_number": "865-288-1548",
            "fax_number": "865-377-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11440 PARKSIDE DR",
            "address_2": "SUITE 302",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379342658",
            "telephone_number": "865-288-1548",
            "fax_number": "865-377-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACULTY INTERNAL MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "865-288-1548",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.