Individual provider Active NPI

Amit Patel, M.D.

  • Pediatrics Physician
  • Knoxville, TN
National Provider Identifier
1407844111
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
39761 Issued in TN
Practice address
2018 Clinch Ave
Knoxville, TN 37916
Phone
(865) 541-8105
NPI assigned
Oct 7, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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 39761 TN
Pediatrics Physician 208000000X 39761 TN Primary

Addresses

Primary practice location

2018 Clinch Ave
Knoxville, TN 37916

Mailing address

1000 Andover View LN
Knoxville, TN 37922-7706
Phone (865) 671-3805

Other identifiers 1

IdentifierTypeStateIssuer
287222937AMedicaidGA

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
I20050617000972 TN Practitioner - Pediatric Medicine 3375587561 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39761TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Oct 1, 2011 Accepting new patients
East Tennessee Children'S Hospital Association, Inc. Past Accepting new patients

Locations

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

2018 Clinch Ave
Knoxville, TN 37916
Phone (865) 541-8000

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": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1407844111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ANDOVER VIEW LN",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379227706",
            "telephone_number": "865-671-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 CLINCH AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37916",
            "telephone_number": "865-541-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "AMIT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "39761",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "39761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287222937A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.