Individual provider Active NPI

Stephanie Smith Becker, MD

  • Internal Medicine Physician
  • Knoxville, TN
National Provider Identifier
1548208325
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
31847 Issued in TN
Practice address
220 Fort Sanders West Blvd Ste 301
Knoxville, TN 37922-3398
Phone
(865) 690-3003
Fax
(865) 374-2143
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 31847 TN Primary

Addresses

Primary practice location

220 Fort Sanders West Blvd Ste 301
Knoxville, TN 37922-3398

Mailing address

9330 Park West Blvd
Suite 402
Knoxville, TN 37923-4308
Phone (865) 690-3003

Other identifiers 1

IdentifierTypeStateIssuer
3862596MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address becker.stephanie@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040917000864 TN Practitioner - Internal Medicine 1658349675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1996
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

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31847TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. Internal Medicine CurrentSince Feb 1, 2015 Accepting new patients
Covenant Medical Group, Inc CurrentSince Feb 1, 2015 Accepting new patients

Locations

9330 Park West Blvd
Ste 402
Knoxville, TN 37923
Phone (865) 690-3003

220 Fort Sanders West Blvd
Ste 301
Knoxville, TN 37922
Phone (865) 690-3003

Dept 888179
Knoxville, TN 37995

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

Interoperability endpoints

  • Direct secure messaging: becker.stephanie@covenanthealth.cernerdirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1548208325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 PARK WEST BLVD",
            "address_2": "SUITE 402",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234308",
            "telephone_number": "865-690-3003",
            "fax_number": "865-690-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 FORT SANDERS WEST BLVD STE 301",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223398",
            "telephone_number": "865-690-3003",
            "fax_number": "865-374-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "STEPHANIE",
        "middle_name": "SMITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "31847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3862596",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "becker.stephanie@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "220 Fort Sanders West Blvd Ste 301",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379223398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.