Individual provider Active NPI

A B M Nasibul Alam, M.B.B.S.

  • Internal Medicine Physician
  • Knoxville, TN
National Provider Identifier
1457095051
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125.080879 Issued in IL
Practice address
1940 Alcoa Hwy Ste 210
Knoxville, TN 37920-2264
Phone
(865) 524-7471
NPI assigned
Apr 21, 2022
Reactivated
Apr 26, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.080879 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1940 Alcoa Hwy Ste 210
Knoxville, TN 37920-2264

Mailing address

6315 Kingston Pike Apt 1301
Knoxville, TN 37919-4917
Phone (815) 482-2717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240325001683 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8325485469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125.080879ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1457095051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6315 KINGSTON PIKE APT 1301",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194917",
            "telephone_number": "815-482-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 ALCOA HWY STE 210",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379202264",
            "telephone_number": "865-524-7471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAM",
        "first_name": "A B M NASIBUL",
        "credential": "M.B.B.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-21",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "deactivation_date": "2023-01-18",
        "reactivation_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.080879",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.