Individual provider Active NPI

Camilla C Bennett, MD

  • Family Medicine Physician
  • Knoxville, TN
National Provider Identifier
1497734073
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD0000027512 Issued in TN
Practice address
200 Fort Sanders West Blvd
Ste 107, MDB 1
Knoxville, TN 37922-3357
Phone
(865) 670-1003
Fax
(865) 670-1004
NPI assigned
Jan 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD0000027512 TN Primary

Addresses

Primary practice location

200 Fort Sanders West Blvd
Ste 107, MDB 1
Knoxville, TN 37922-3357

Mailing address

200 Fort Sanders West Blvd
Ste 107, MDB 1
Knoxville, TN 37922-3357
Phone (865) 670-1003

Other identifiers 1

IdentifierTypeStateIssuer
Q013407MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000027512TNMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1497734073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FORT SANDERS WEST BLVD",
            "address_2": "STE 107, MDB 1",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223357",
            "telephone_number": "865-670-1003",
            "fax_number": "865-670-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FORT SANDERS WEST BLVD",
            "address_2": "STE 107, MDB 1",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223357",
            "telephone_number": "865-670-1003",
            "fax_number": "865-670-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "CAMILLA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-12",
        "last_updated": "2026-02-12",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000027512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q013407",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Feb 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.