Individual provider Active NPI

Ellen F Liuzza, MD

  • Internal Medicine Physician
  • Oak Ridge, TN
National Provider Identifier
1437158920
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
41358 Issued in KY
Practice address
100 Vermont Ave
Oak Ridge, TN 37830-6471
Phone
(865) 482-1777
Fax
(865) 482-1030
NPI assigned
Jul 18, 2005
Last updated
Oct 31, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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 41358 KY Primary

Addresses

Primary practice location

100 Vermont Ave
Oak Ridge, TN 37830-6471

Mailing address

100 Vermont Ave
Oak Ridge, TN 37830-6471
Phone (865) 482-1777

Other identifiers 6

IdentifierTypeStateIssuer
50024216OtherKYPASSPORT
Q017377MedicaidTN
000000613609OtherKYANTHEM
P00754793OtherKYRAILROAD MEDICARE
3718940000OtherKYPASSPORT ADVANTAGE
7100083480MedicaidKY

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
I20040514000646 TN Practitioner - Internal MedicinePractitioner - Emergency Medicine 4587654272 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tulane University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

100 Vermont Ave
Oak Ridge, TN 37830-6471
Phone (865) 482-1777

111 Clyde St
Loudon, TN 37774-1600
Phone (865) 458-1554

6600 Nightingale LN
Knoxville, TN 37909-2754
Phone (865) 632-5885

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41358KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. Internal Medicine CurrentSince Nov 1, 2016 Accepting new patients
Summit Medical Group, PLLC CurrentSince Nov 2, 2015 Accepting new patients
Summit Medical Group, PLLC Internal Medicine CurrentSince Nov 2, 2015 Accepting new patients
Covenant Medical Group, Inc CurrentSince Nov 1, 2016 Accepting new patients
Baptist Health Medical Group Inc Past Accepting new patients
Abercrombie Radiological Consultants Inc Past Accepting new patients

Locations

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

3403 Tazewell Pike
Ste 101
Knoxville, TN 37918
Phone (865) 687-2303

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

100 Vermont Ave
Oak Ridge, TN 37830
Phone (865) 482-1777

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1437158920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VERMONT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306471",
            "telephone_number": "865-482-1777",
            "fax_number": "865-482-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VERMONT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306471",
            "telephone_number": "865-482-1777",
            "fax_number": "865-482-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIUZZA",
        "first_name": "ELLEN",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "41358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50024216",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q017377",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000613609",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00754793",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "3718940000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100083480",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.