Individual provider Active NPI

Andrew Schmudde, PA

  • Physician Assistant
  • Knoxville, TN
National Provider Identifier
1477649564
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
461 Issued in TN
Practice address
1300 Old Weisgarber Rd
Knoxville, TN 37909-1291
Phone
(865) 584-2146
Fax
(865) 584-9660
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 461 TN Primary

Addresses

Primary practice location

1300 Old Weisgarber Rd
Knoxville, TN 37909-1291

Mailing address

PO Box 52268
Knoxville, TN 37950-2268
Phone (865) 584-2146

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address schmudde.andrew@covenanthealth.cernerdirect.com

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080416000302 TN Practitioner - Physician Assistant 8123106135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

111 Clyde St
Loudon, TN 37774-1600
Phone (865) 458-1554

1300 Old Weisgarber Rd
Knoxville, TN 37909-1291
Phone (865) 584-2146

1320 Old Weisgarber Rd
Knoxville, TN 37909-1291
Phone (865) 584-1054

6600 Nightingale LN
Knoxville, TN 37909-2754
Phone (865) 632-5885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
461TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. Physician Assistant CurrentSince Jan 1, 2013 Accepting new patients
Covenant Medical Group, Inc CurrentSince Jan 1, 2013 Accepting new patients
Covenant Medical Group, Inc Past Accepting new patients
Familycare Specialists PC Past Accepting new patients

Locations

1320 Old Weisgarber Rd
Knoxville, TN 37909
Phone (865) 584-1054

Dept 888179
Knoxville, TN 37995

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

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1477649564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52268",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379502268",
            "telephone_number": "865-584-2146",
            "fax_number": "865-584-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 OLD WEISGARBER RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091291",
            "telephone_number": "865-584-2146",
            "fax_number": "865-584-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMUDDE",
        "first_name": "ANDREW",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "schmudde.andrew@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1300 Old Weisgarber Rd",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379091291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.