Individual provider Active NPI

Torey Michael Killom, D.O.

  • Emergency Medicine Physician
  • Knoxville, TN
National Provider Identifier
1356780894
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
3017 Issued in TN
Practice address
1924 Alcoa Hwy
U-67
Knoxville, TN 37920-1511
Phone
(865) 305-5087
NPI assigned
Jun 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 3017 TN Primary
Internal Medicine Physician 207R00000X LL35696 SC

Addresses

Primary practice location

1924 Alcoa Hwy
U-67
Knoxville, TN 37920-1511

Mailing address

1701 Francis Rd
Unit a
Knoxville, TN 37909-5006
Phone (864) 455-7882

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
I20170118001646 TN Practitioner - Emergency Medicine 2961636493 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

1114 W Madison Ave
Athens, TN 37303-4150
Phone (423) 741-1411

Hospital & facility affiliations

  • Affiliate of Vitruvian Health Hospital, Cleveland, TN, CCN 440185

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL35696SCMDInternal Medicine Physician
35696SCMDGynecologic Oncology Physician
3017TNMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Feb 8, 2017 Accepting new patients
App of Tennessee Ed, PLLC Emergency Medicine CurrentSince Aug 21, 2017 Accepting new patients
Medical Observation Services LLC Emergency Medicine Past Accepting new patients

Locations

1114 W Madison Ave
Athens, TN 37303
Phone (423) 744-3256

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

1924 Alcoa Hwy
#U67
Knoxville, TN 37920
Phone (865) 305-9350

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

Interoperability endpoints

  • Direct secure messaging: dr_torey_killom@yourcarecommunity.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1356780894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 FRANCIS RD",
            "address_2": "UNIT A",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379095006",
            "telephone_number": "864-455-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY",
            "address_2": "U-67",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511",
            "telephone_number": "865-305-5087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLOM",
        "first_name": "TOREY",
        "middle_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-18",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "3017",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL35696",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.