Individual provider Active NPI

Angela Josetta Liske, M.D.

  • Family Medicine Physician
  • Knoxville, TN
National Provider Identifier
1346400520
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD0000033943 Issued in TN
Practice address
2018 Western Ave
Knoxville, TN 37921-5718
Phone
(865) 544-0406
Fax
(865) 544-0480
NPI assigned
Jun 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD0000033943 TN Primary

Addresses

Primary practice location

2018 Western Ave
Knoxville, TN 37921-5718

Mailing address

6350 W Andrew Johnson Hwy
Department 100
Talbott, TN 37877-8605
Phone (800) 355-3565

Other names 1

  • Angela Josetta Coppock Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address angela.liske.p1@direct.cherokeehealth.nextgenshare.com Direct

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
I20170908000784 TN Practitioner - Family Practice 7214209816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee Health SystemsGroup PAC ID 3577474295, 128 clinicians

Practice addresses (Care Compare)

2018 Western Ave
Knoxville, TN 37921-5718
Phone (423) 317-9344

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000033943TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Health Systems CurrentSince May 16, 2017 Accepting new patients
Cherokee Health Systems Family Medicine CurrentSince May 16, 2017 Accepting new patients

Locations

1285 Highway 11W
Bean Station, TN 37708
Phone (865) 993-4300

2018 Western Ave
Knoxville, TN 37921
Phone (865) 544-0406

1923 Sulphur Springs Rd
Morristown, TN 37813

6350 W Andrew Johnson Hwy
#100
Talbott, TN 37877
Phone (423) 586-5031

Interoperability endpoints

  • Direct secure messaging: angela.liske.p1@direct.cherokeehealth.nextgenshare.com

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": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1346400520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6350 W ANDREW JOHNSON HWY",
            "address_2": "DEPARTMENT 100",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "378778605",
            "telephone_number": "800-355-3565",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 WESTERN AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379215718",
            "telephone_number": "865-544-0406",
            "fax_number": "865-544-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISKE",
        "first_name": "ANGELA",
        "middle_name": "JOSETTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000033943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "angela.liske.p1@direct.cherokeehealth.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Message Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Message Address",
            "address_1": "2018 Western Ave",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379215718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "COPPOCK",
            "middle_name": "JOSETTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.