Organization Active NPI

Dermatopathology Partners PC

  • Dermatopathology (Pathology) Physician
  • Knoxville, TN
National Provider Identifier
1528330644
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
Legal business name
DERMATOPATHOLOGY PARTNERS PC
Practice address
139 Fox Rd Ste 204
Knoxville, TN 37922-3472
Phone
(865) 474-8866
Fax
(865) 560-2784
NPI assigned
Feb 5, 2012
Last updated
Nov 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Authorized official

Name
Dr. Neil M. Coleman, M.D.NPI 1598951303
Title
President
Phone
(865) 474-8866

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X Primary

Addresses

Primary practice location

139 Fox Rd Ste 204
Knoxville, TN 37922-3472

Mailing address

Dept 888136
Knoxville, TN 37995-0001
Phone (865) 670-6199

Other practice location 1

123 Fox Rd Ste 201
Knoxville, TN 37922-3369
Phone (865) 474-8866

Other practice location 2

19126 W Riverview Dr
Post Falls, ID 83854-7718
Phone (210) 386-0053

Other identifiers 1

IdentifierTypeStateIssuer
1527099MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120314000475 TN Part B Supplier - Clinic/Group Practice 1951560739 Receives reassigned benefits from 11 practitioners
Practice locations: Knoxville, TN
O20200416003131 ID Part B Supplier - Clinic/Group Practice 1951560739 Receives reassigned benefits from 1 practitioner
Practice locations: Post Falls, ID

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2036655Dermatopathology Partners PC139 Fox Road, Ste 204, Knoxville, TN 37922ComplianceJun 17, 2028

National Provider Directory

National Provider Directory

Locations

123 Fox Rd
Ste 201
Knoxville, TN 37922
Phone (865) 474-8866

139 Fox Rd
Ste 20
Knoxville, TN 37922

139 Fox Rd
Ste 203
Knoxville, TN 37922
Phone (865) 474-8866

139 Fox Rd
Ste 204
Knoxville, TN 37922
Phone (865) 201-2560

Dept 888136
Knoxville, TN 37995

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1328400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1528330644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 888136",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379950001",
            "telephone_number": "865-670-6199",
            "fax_number": "865-670-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 FOX RD STE 204",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223472",
            "telephone_number": "865-474-8866",
            "fax_number": "865-560-2784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Fox Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379223369",
            "country_code": "US",
            "telephone_number": "865-474-8866",
            "fax_number": "865-560-2784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19126 W Riverview Dr",
            "address_purpose": "LOCATION",
            "city": "Post Falls",
            "state": "ID",
            "postal_code": "838547718",
            "country_code": "US",
            "telephone_number": "210-386-0053",
            "fax_number": "972-600-8137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DERMATOPATHOLOGY PARTNERS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-05",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-474-8866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1527099",
            "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 Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.