Individual provider Active NPI

Candace A Robertson, MD

  • Anesthesiology Physician
  • Knoxville, TN
National Provider Identifier
1457359689
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
26937 Issued in TN
Practice address
137 Blount Ave
Knoxville, TN 37901
Phone
(865) 632-5161
NPI assigned
Jul 12, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 26937 TN Primary

Addresses

Primary practice location

137 Blount Ave
Knoxville, TN 37901

Mailing address

5230 Hickory Hollow Rd
Knoxville, TN 37919-9300
Phone (865) 558-3004

Other identifiers 1

IdentifierTypeStateIssuer
3091698MedicaidTN

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
I20040108000981 TN Practitioner - Anesthesiology 3274433164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Wake Forest University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Laurel Falls Anesthesiologists PLLCGroup PAC ID 8921452673, 8 clinicians

Practice addresses (Care Compare)

907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015
Phone (865) 977-5760

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26937TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Laurel Falls Anesthesiologists, PLLC Anesthesiology CurrentSince Jun 27, 2023 Accepting new patients
East Tennessee Women's Care, PC Past Accepting new patients
Health Ventures, Inc Past Accepting new patients
Anesthesia Consultants of Knoxville, PC Anesthesiology Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: crobertson872659@direct.ghs.myhfn.org

Organizations & group practices 4

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457359689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5230 HICKORY HOLLOW RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379199300",
            "telephone_number": "865-558-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 BLOUNT AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37901",
            "telephone_number": "865-632-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "CANDACE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "26937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3091698",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.