Individual provider Active NPI

Randall E Pearson, M.D.

  • Urology Physician
  • Oak Ridge, TN
National Provider Identifier
1639179682
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD0000014439 Issued in TN
Practice address
800 Oak Ridge Turn Pike
Suite a-101
Oak Ridge, TN 37830-6927
Phone
(865) 483-1093
Fax
(865) 482-8629
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD0000014439 TN Primary

Addresses

Primary practice location

800 Oak Ridge Turn Pike
Suite a-101
Oak Ridge, TN 37830-6927

Mailing address

25 Crossroads Dr Ste 306
Owings Mills, MD 21117-5437
Phone (443) 738-2872

Other identifiers 6

IdentifierTypeStateIssuer
020247799OtherTNEEOICP
1669416442OtherTNGROUP NPI
3106049OtherTNBLUE CROSS
3025129MedicaidTN
CI2260OtherTNRAILROAD MEDICARE
3106044OtherTNBLUE CROSS

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
I20100303000103 TN Practitioner - Urology 7416046438 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000014439TNMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Urology Associates, PLLC Urology CurrentSince Jan 1, 1999 Accepting new patients
Tennessee Urology Associates, PLLC Urology CurrentSince Jan 1, 1999 Accepting new patients

Locations

25 Crossroads Dr
Ste 306
Owings Mills, MD 21117
Phone (443) 231-1681

1855 Tanner Way
Ste 240
Harriman, TN 37748
Phone (865) 316-3985

9724 Kingston Pike
Ste 800
Knoxville, TN 37922

9724 Kingston Pike
Knoxville, TN 37922
Phone (865) 310-5008

800 Oak Ridge Tpke
Ste A101
Oak Ridge, TN 37830
Phone (865) 483-1093

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.

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1639179682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CROSSROADS DR STE 306",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175437",
            "telephone_number": "443-738-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 OAK RIDGE TURN PIKE",
            "address_2": "SUITE A-101",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306927",
            "telephone_number": "865-483-1093",
            "fax_number": "865-482-8629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "RANDALL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "MD0000014439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EEOICP",
            "identifier": "020247799",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1669416442",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3106049",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3025129",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI2260",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3106044",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.