NPIMap

Organization Active NPI

Afc Physicians of Tennessee, PC

  • General Practice Physician
  • Knoxville, TN
National Provider Identifier
1649647249
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
AFC PHYSICIANS OF TENNESSEE, PC
Practice address
9203 Kingston Pike
Knoxville, TN 37922-2318
Phone
(865) 299-6192
Fax
(865) 299-6196
NPI assigned
Aug 31, 2015
Last updated
Jun 12, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
AFC PHYSICIANS OF TENNESSEE, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Authorized official

Name
Mr. Randy Johansen
Title
President
Phone
(205) 421-2101

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

9203 Kingston Pike
Knoxville, TN 37922-2318

Mailing address

3700 Cahaba Beach Rd
Birmingham, AL 35242-5225
Phone (205) 403-8902

Other names 1

  • American Family Care Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110128000880 TN Part B Supplier - Clinic/Group Practice 5395924823 Receives reassigned benefits from 114 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Knoxville, TN; Spring Hill, TN; Smyrna, TN; Nashville, TN; Hendersonville, TN; Clarksville, TN; Chattanooga, TN; Mt. Juliet, TN…

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2100570American Family Care-Cedar Bluff9203 Kingston Pike, Knoxville, TN 37922Certificate of waiverAug 29, 2026

National Provider Directory

National Provider Directory
Tax ID family
Afc Physician of TN PC7 organizations share this tax ID, including this one
Part of
Afc Physician of TN PC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1763 Madison St
Clarksville, TN 37043
Phone (931) 278-8000

291 Indian Lake Blvd
Hendersonville, TN 37075
Phone (615) 265-5008

Practitioners & affiliated clinicians

Practitioners 110

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 110

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591920000000",
    "number": "1649647249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 CAHABA BEACH RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425225",
            "telephone_number": "205-403-8902",
            "fax_number": "205-421-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9203 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379222318",
            "telephone_number": "865-299-6192",
            "fax_number": "865-299-6196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFC PHYSICIANS OF TENNESSEE, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AFC PHYSICIANS OF TENNESSEE, PC",
        "enumeration_date": "2015-08-31",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A",
        "authorized_official_last_name": "JOHANSEN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-421-2101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Family Care",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "American Family Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.