Individual provider Active NPI

Angela Adkisson, PA

  • Physician Assistant
  • Oak Ridge, TN
National Provider Identifier
1598851602
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
796 Issued in TN
Practice address
988 Oak Ridge Tpke Ste 140
Oak Ridge, TN 37830-6919
Phone
(865) 483-7415
Fax
(865) 483-7980
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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 796 TN Primary

Addresses

Primary practice location

988 Oak Ridge Tpke Ste 140
Oak Ridge, TN 37830-6919

Mailing address

988 Oak Ridge Tpke Ste 140
Oak Ridge, TN 37830-6919
Phone (865) 483-7415

Other practice location 1

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

Other identifiers 1

IdentifierTypeStateIssuer
3669713MedicaidTN

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
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Obstetric & Gyncologic Assocs of Oak Ridge PastSince Sep 1, 2016 Accepting new patients
Familycare Specialists PC Past Accepting new patients
Covenant Medical Group, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: angela.adkisson@tn046.digichart.direct-ci.com

Organizations & group practices 3

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": "1559692800000",
    "number": "1598851602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 OAK RIDGE TPKE STE 140",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306919",
            "telephone_number": "865-483-7415",
            "fax_number": "865-483-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 OAK RIDGE TPKE STE 140",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306919",
            "telephone_number": "865-483-7415",
            "fax_number": "865-483-7980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Old Weisgarber Rd",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379091291",
            "country_code": "US",
            "telephone_number": "865-584-2146",
            "fax_number": "865-584-9660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADKISSON",
        "first_name": "ANGELA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3669713",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.