Individual provider Active NPI

Joseph Bruce Eatherly, M.D.

  • Specialist
  • Oak Ridge, TN
National Provider Identifier
1295744753
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD0000013891 Issued in TN
Practice address
129 E Division Rd
Oak Ridge, TN 37830-6907
Phone
(865) 482-9633
Fax
(865) 482-9655
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD0000013891 TN Primary

Addresses

Primary practice location

129 E Division Rd
Oak Ridge, TN 37830-6907

Mailing address

129 E Division Rd
Oak Ridge, TN 37830-6907
Phone (865) 482-9633

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
I20111018000700 TN Practitioner - Pathology 9133124928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Tennessee, HSC, College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tennessee Urology Associates, PLLCGroup PAC ID 7618952706, 27 clinicians

Practice addresses (Care Compare)

800 Oak Ridge Tpke
A101
Oak Ridge, TN 37830-6927
Phone (865) 483-1093

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000013891TNMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Urology Associates, PLLC CurrentSince Jul 1, 2013 Accepting new patients
Tennessee Urology Associates, PLLC CurrentSince Jul 1, 2013 Accepting new patients
Pathology Medical Associates, PLLC Specialist CurrentSince Mar 2, 2003 Accepting new patients

Locations

25 Crossroads Dr
Ste 306
Owings Mills, MD 21117
Phone (443) 231-1681

800 Oak Ridge Tpke
Ste A101
Oak Ridge, TN 37830
Phone (865) 483-1093

129 E Division Rd
Oak Ridge, TN 37830
Phone (865) 482-3633

7557 Dannaher Dr
Ste 230
Powell, TN 37849
Phone (865) 938-5222

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1295744753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 E DIVISION RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306907",
            "telephone_number": "865-482-9633",
            "fax_number": "865-482-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 E DIVISION RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306907",
            "telephone_number": "865-482-9633",
            "fax_number": "865-482-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATHERLY",
        "first_name": "JOSEPH",
        "middle_name": "BRUCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD0000013891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.