NPIMap

Organization Active NPI

University Health System, Inc

Doing business as UT Family Physicians Northshore

  • Family Medicine Physician
  • Knoxville, TN
National Provider Identifier
1477649226
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNIVERSITY HEALTH SYSTEM, INC
Doing business as
UT Family Physicians Northshore
Practice address
9625 Kroger Park Dr
Ste 400
Knoxville, TN 37922-5880
Phone
(865) 539-2411
Fax
(865) 539-2412
NPI assigned
Oct 5, 2006
Last updated
Jun 24, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Authorized official

Name
Cynthia B. Marquart
Title
Vice President
Phone
(865) 305-9886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X TN Primary

Addresses

Primary practice location

9625 Kroger Park Dr
Ste 400
Knoxville, TN 37922-5880

Mailing address

PO Box 440525
Nashville, TN 37244-0525
Phone (865) 670-6199

Other identifiers 1

IdentifierTypeStateIssuer
3710173MedicaidTN

Other names 1

  • UT Family Physicians Northshore Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000809 TN Part B Supplier - Clinic/Group Practice 5294646378 Receives reassigned benefits from 881 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
University Health Sys Inc67 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

9625 Kroger Park Dr
#400
Knoxville, TN 37922
Phone (865) 539-2411

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308873600000",
    "number": "1477649226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 440525",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372440525",
            "telephone_number": "865-670-6199",
            "fax_number": "865-670-6158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9625 KROGER PARK DR",
            "address_2": "STE 400",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379225880",
            "telephone_number": "865-539-2411",
            "fax_number": "865-539-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY HEALTH SYSTEM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2011-06-24",
        "status": "A",
        "authorized_official_last_name": "MARQUART",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "865-305-9886"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3710173",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UT Family Physicians Northshore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 24, 2011; 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.