Individual provider Active NPI

Mark Nelson, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Knoxville, TN
National Provider Identifier
1336117944
Registry record updated Jul 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
15357 Issued in TN
Practice address
501 20TH St
Suite 606
Knoxville, TN 37916-1809
Phone
(865) 546-8040
Fax
(865) 541-2787
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 15357 TN Primary

Addresses

Primary practice location

501 20TH St
Suite 606
Knoxville, TN 37916-1809

Mailing address

501 20TH St
Suite 606
Knoxville, TN 37916-1809
Phone (865) 546-8040

Other identifiers 5

IdentifierTypeStateIssuer
P00168918OtherTNTRAVELERS MEDICARE
4087758OtherTNBLUE CROSS
4087758OtherTNBLUECARE
100024069OtherTNPHP TENNCARE
3008471MedicaidTN

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
I20040910000322 TN Practitioner - AnesthesiologyPractitioner - Pain Management 0042287054 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15357TNMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Tennessee, P.C. CurrentSince Oct 1, 2004 Accepting new patients
American Anesthesiology of Tennessee, P.C. Past Accepting new patients

Locations

501 20th St
Ste 606
Knoxville, TN 37916
Phone (865) 331-2278

900 E Hill Ave
Knoxville, TN 37915
Phone (865) 545-7817

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

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.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311724800000",
    "number": "1336117944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 20TH ST",
            "address_2": "SUITE 606",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161809",
            "telephone_number": "865-546-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 20TH ST",
            "address_2": "SUITE 606",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161809",
            "telephone_number": "865-546-8040",
            "fax_number": "865-541-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2011-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TN",
            "license": "15357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "P00168918",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4087758",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECARE",
            "identifier": "4087758",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP TENNCARE",
            "identifier": "100024069",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3008471",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.