NPIMap

Individual provider Active NPI

Carl S Orthoefer, MD

  • Internal Medicine Physician
  • Knoxville, TN
National Provider Identifier
1629013701
Registry record updated Oct 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
31404 Issued in TN
Practice address
2240 Sutherland Ave
Ste 104
Knoxville, TN 37919-2333
Phone
(865) 909-0090
Fax
(865) 909-9883
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2013

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 31404 TN Primary

Addresses

Primary practice location

2240 Sutherland Ave
Ste 104
Knoxville, TN 37919-2333

Mailing address

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909-2604
Phone (865) 584-4747

Other identifiers 2

IdentifierTypeStateIssuer
3851861MedicaidTN
110205242OtherTNRR MEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100223000722 TN Practitioner - Internal Medicine 7113005133

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

466 Cherokee Blvd
Knoxville, TN 37919-6614

7725 W Reno Ave
Suite 330
Oklahoma City, OK 73127-9742

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Statcare Inpatient LLC Internal Medicine CurrentSince Jul 1, 2017 Accepting new patients
Fort Sanders Regional Medical Center Past Accepting new patients
Summit Medical Group,PLLC Internal Medicine Past Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients

Locations

2240 Sutherland Ave
Ste 104
Knoxville, TN 37919
Phone 8659090090 ext. 222

1901 Clinch Ave
#4N
Knoxville, TN 37916

1901 Clinch Ave
Knoxville, TN 37916
Phone (865) 331-1111

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Fort Sanders Transitional Care UnitKnoxville, TN, CCN 445328 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2022
May 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 6

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1629013701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E WEISGARBER RD",
            "address_2": "STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092604",
            "telephone_number": "865-584-4747",
            "fax_number": "865-584-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 SUTHERLAND AVE",
            "address_2": "STE 104",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379192333",
            "telephone_number": "865-909-0090",
            "fax_number": "865-909-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTHOEFER",
        "first_name": "CARL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "31404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3851861",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "110205242",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.