NPIMap

Organization Active NPI

Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
National Provider Identifier
1457302010
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COVENANT MEDICAL GROUP, INC.
Practice address
1420 Centerpoint Blvd
Knoxville, TN 37932-1960
Phone
(865) 374-5200
Fax
(865) 374-2155
NPI assigned
May 16, 2006
Last updated
Oct 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Mr. Craig Robert Brent
Title
Vice President
Phone
(865) 374-5104

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Cardiovascular Disease Physician 207RC0000X NU
Clinical Cardiac Electrophysiology Physician 207RC0001X NU
Interventional Cardiology Physician 207RI0011X NU
Pulmonary Disease Physician 207RP1001X NU
Neurological Surgery Physician 207T00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Physical Medicine & Rehabilitation Physician 208100000X NU
Neurology Physician 2084N0400X NU
Surgery Physician 208600000X NU
Urology Physician 208800000X NU
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU
Sleep Medicine (Internal Medicine) Physician 207RS0012X NU

Addresses

Primary practice location

1420 Centerpoint Blvd
Knoxville, TN 37932-1960

Mailing address

1420 Centerpoint Blvd
Knoxville, TN 37932-1960
Phone (865) 374-5200

Other identifiers 1

IdentifierTypeStateIssuer
3734041MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060719000030 TN Part B Supplier - Clinic/Group Practice 2860305463 Receives reassigned benefits from 554 practitioners

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

205 Corporate Pl
Alcoa, TN 37701
Phone (865) 331-9050

102 S Seivers Blvd
Clinton, TN 37716
Phone (865) 457-4702

132 Stonehenge Dr
Crossville, TN 38558
Phone (931) 459-7660

1855 Tanner Way
Ste 220
Harriman, TN 37748
Phone (865) 882-2442

1300 Old Weisgarber Rd
Knoxville, TN 37909
Phone (865) 584-2146

1400 Centerpoint Blvd
Ste 202
Knoxville, TN 37932

1819 Clinch Ave
Ste 110
Knoxville, TN 37916
Phone (865) 331-9075

220 Fort Sanders West Blvd
Ste 200
Knoxville, TN 37922
Phone (423) 346-5566

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

8707 Asheville Hwy
Knoxville, TN 37924
Phone (423) 933-4159

9320 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-7100

9330 Park West Blvd
Ste 200
Knoxville, TN 37923
Phone (865) 373-5100

9330 Park West Blvd
Ste 302
Knoxville, TN 37923
Phone (865) 373-7975

Dept 888179
Knoxville, TN 37995

689 Medical Park Dr
Ste 204
Lenoir City, TN 37772
Phone (865) 271-6670

689 Medical Park Dr
Ste 300
Lenoir City, TN 37772
Phone (865) 988-9970

1921 Topside Rd
Ste 200
Louisville, TN 37777
Phone (865) 374-0560

1934 E Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 331-4510

988 Oak Ridge Tpke
Ste 200
Oak Ridge, TN 37830
Phone (865) 483-4366

110 Industrial Park Ln
Rocky Top, TN 37769
Phone (865) 426-7421

627 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 365-4233

744 Middle Creek Rd
Ste 108
Sevierville, TN 37862
Phone (865) 446-9500

Practitioners & affiliated clinicians

Practitioners 600

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 600

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1457302010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 CENTERPOINT BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321960",
            "telephone_number": "865-374-5200",
            "fax_number": "865-374-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 CENTERPOINT BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321960",
            "telephone_number": "865-374-5200",
            "fax_number": "865-374-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "BRENT",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "865-374-5104",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3734041",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.