Individual provider Active NPI

Karl E Studtmann, M.D.

  • Otolaryngology Physician
  • Jackson, TN
National Provider Identifier
1477545283
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD31461 Issued in TN
Practice address
145 Innovation Dr
Jackson, TN 38305-3019
Phone
(731) 422-0213
Fax
(731) 422-0297
NPI assigned
Aug 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD31461 TN Primary

Addresses

Primary practice location

145 Innovation Dr
Jackson, TN 38305-3019

Mailing address

PO Box 400
Jackson, TN 38302-0400
Phone (731) 423-8697

Other identifiers 1

IdentifierTypeStateIssuer
3841329MedicaidTN

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
I20111103000159 TN Practitioner - Otolaryngology 4385793777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Tennessee, HSC, College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Clinic PAGroup PAC ID 2668376872, 171 clinicians

Practice addresses (Care Compare)

145 Innovation Dr
Jackson, TN 38305-3019
Phone (731) 422-0213

Hospital & facility affiliations

  • Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
  • Baptist Memorial Hospital - Carroll County Hospital, Huntingdon, TN, CCN 440016

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
74.15
Promoting interoperability
77
Improvement activities
40
Cost
78.84

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision12
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD31461TNMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinic PA CurrentSince Aug 1, 2024 Accepting new patients
Jackson Clinic PA Otolaryngology CurrentSince Aug 1, 2024 Accepting new patients

Locations

87 Murray Guard Dr
Ste B
Jackson, TN 38305
Phone (731) 664-1375

145 Innovation Dr
Jackson, TN 38305

619 Skyline Dr
Jackson, TN 38301
Phone (731) 424-3682

Interoperability endpoints

  • Direct secure messaging: karlstudtmann@jcpa.allscriptsdirect.net

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.

Hospital & facility affiliations 2

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1477545283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383020400",
            "telephone_number": "731-423-8697",
            "fax_number": "731-425-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 INNOVATION DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053019",
            "telephone_number": "731-422-0213",
            "fax_number": "731-422-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUDTMANN",
        "first_name": "KARL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TN",
            "license": "MD31461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3841329",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.