Individual provider Active NPI

Corey Fussell, M.D.

  • Family Medicine Physician
  • Oak Ridge, TN
National Provider Identifier
1497103824
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
82311 Issued in GA
Practice address
200 New York Ave Ste 150
Oak Ridge, TN 37830-5227
Phone
(865) 835-5850
Fax
(865) 374-1115
NPI assigned
May 26, 2016
Last updated
Mar 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 76469 TN
Family Medicine Physician 207Q00000X 82311 GA Primary

Addresses

Primary practice location

200 New York Ave Ste 150
Oak Ridge, TN 37830-5227

Mailing address

200 New York Ave Ste 150
Oak Ridge, TN 37830-5227
Phone (865) 835-5850

Other identifiers 1

IdentifierTypeStateIssuer
Q042768MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fussell.corey.carter@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190826003942 GA Practitioner - Family Practice 5294063483 Reassigns benefits to 2 organizations
I20260304000576 TN Practitioner - Family Practice 5294063483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

117 Harmony Xing
Suite 1
Eatonton, GA 31024-9548
Phone (762) 320-2100

200 New York Ave
Suite 150
Oak Ridge, TN 37830-5227
Phone (865) 835-5850

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82311GAMDFamily Medicine Physician
76469TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC Family Medicine CurrentSince Jan 25, 2025 Accepting new patients
Upson Family Physicians, LC Family Medicine CurrentSince Aug 1, 2019 Accepting new patients
Privia Medical Group of Georgia LLC Family Medicine CurrentSince Jan 25, 2025 Accepting new patients
Covenant Medical Group, Inc. Family Medicine CurrentSince Feb 1, 2026 Accepting new patients
Archwell Health Medical of Florida, LLC CurrentSince Oct 22, 2023 Accepting new patients
Covenant Medical Group, Inc CurrentSince Feb 1, 2026 Accepting new patients
Healthy Ever After, Inc Past Accepting new patients
Upson Medical Associates LLC Family Medicine PastSince Aug 1, 2019 Accepting new patients

Locations

880 49th St N
St Petersburg, FL 33710
Phone (727) 405-7188

543 Tamiami Trl S
Venice, FL 34285
Phone (941) 837-8002

3715 Northside Pkwy NW
Bldg 100
Atlanta, GA 30327
Phone (770) 680-1473

117 Harmony Xing
Ste 1
Eatonton, GA 31024
Phone (706) 485-4004

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

250 Mlk Blvd
Macon, GA 31201
Phone (478) 301-2362

915 W Gordon St
#B
Thomaston, GA 30286
Phone (706) 647-7009

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

200 New York Ave
Ste 150
Oak Ridge, TN 37830
Phone (865) 481-0200

Interoperability endpoints

  • Direct secure messaging: corey.fussell.1@8042.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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 5

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": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1497103824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEW YORK AVE STE 150",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378305227",
            "telephone_number": "865-835-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NEW YORK AVE STE 150",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378305227",
            "telephone_number": "865-835-5850",
            "fax_number": "865-374-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSSELL",
        "first_name": "COREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-26",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "76469",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "82311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q042768",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fussell.corey.carter@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "200 New York Ave Ste 150",
            "city": "Oak Ridge",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378305227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.