Individual provider Active NPI

Caroline E Cooley, MD

  • Internal Medicine Physician
  • Knoxville, TN
National Provider Identifier
1336145069
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14796 Issued in TN
Practice address
2240 Sutherland Ave
Suite 104
Knoxville, TN 37919-2333
Phone
(865) 909-0090
Fax
(865) 909-9883
NPI assigned
Jun 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14796 TN Primary

Addresses

Primary practice location

2240 Sutherland Ave
Suite 104
Knoxville, TN 37919-2333

Mailing address

1225 E Weisgarber Rd
Suite 200
Knoxville, TN 37909-2604
Phone (865) 584-4747

Other identifiers 2

IdentifierTypeStateIssuer
1510113MedicaidTN
P00332273OtherTNRR MEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14796TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Homecare CurrentSince Feb 19, 2012 Accepting new patients
Summit Medical Group, PLLC Internal Medicine CurrentSince Jul 1, 2006 Accepting new patients
Summit Medical Group, PLLC Internal Medicine CurrentSince Jul 1, 2006 Accepting new patients
Covenant Homecare CurrentSince Feb 19, 2012 Accepting new patients
Summit Medical Group,PLLC Internal Medicine Past Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients

Locations

3003 Lake Brook Blvd
Ste 101
Knoxville, TN 37909

9333 Park West Blvd
Ste 108
Knoxville, TN 37923
Phone (865) 531-6161

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

2240 Sutherland Ave
Ste 104
Knoxville, TN 37919
Phone 8659090090 ext. 222

Organizations & group practices 6

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1336145069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E WEISGARBER RD",
            "address_2": "SUITE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092604",
            "telephone_number": "865-584-4747",
            "fax_number": "865-584-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 SUTHERLAND AVE",
            "address_2": "SUITE 104",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379192333",
            "telephone_number": "865-909-0090",
            "fax_number": "865-909-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "CAROLINE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "14796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1510113",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "P00332273",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.