NPIMap

Organization Active NPI

Covenant Anesthesia Group, PC

Doing business as MMC Anesthesia Group, PC

  • Anesthesiology Physician
  • Oak Ridge, TN
National Provider Identifier
1639148117
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
COVENANT ANESTHESIA GROUP, PC
Doing business as
MMC Anesthesia Group, PC
Practice address
990 Oak Ridge Tpke
Anesthesia Dept
Oak Ridge, TN 37830-6976
Phone
(865) 691-9000
Fax
(865) 862-7526
NPI assigned
Mar 16, 2006
Last updated
Dec 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Jonathan Russell Frazier, MDNPI 1720056831
Title
President
Phone
(865) 805-9630

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
Anesthesiology Physician 207L00000X TN Primary

Addresses

Primary practice location

990 Oak Ridge Tpke
Anesthesia Dept
Oak Ridge, TN 37830-6976

Mailing address

PO Box 5059
Oak Ridge, TN 37831-5059
Phone (770) 237-1089

Other names 1

  • MMC Anesthesia Group, PC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310001466 TN Part B Supplier - Clinic/Group Practice 6901795830 Receives reassigned benefits from 285 practitioners
Practice locations: Morristown, TN; Sevierville, TN; Oak Ridge, TN; Lenoir City, TN; Knoxville, TN

National Provider Directory

National Provider Directory

Locations

9461 Sherrill Blvd
Knoxville, TN 37932
Phone (865) 531-0494

Dept 888089
Knoxville, TN 37995

Practitioners & affiliated clinicians

Practitioners 336

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 336

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1639148117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5059",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378315059",
            "telephone_number": "770-237-1089",
            "fax_number": "770-237-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 OAK RIDGE TPKE",
            "address_2": "ANESTHESIA DEPT",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306976",
            "telephone_number": "865-691-9000",
            "fax_number": "865-862-7526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT ANESTHESIA GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-16",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-805-9630",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMC Anesthesia Group, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.