Individual provider Active NPI

Stephen Daniel Myers, MD

  • Hematology & Oncology Physician
  • Knoxville, TN
National Provider Identifier
1669444907
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
60120 Issued in TN
Practice address
1915 White Ave
Knoxville, TN 37916
Phone
(865) 331-1720
Fax
(865) 331-2823
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 37769 KY
Hematology & Oncology Physician 207RH0003X 60120 TN Primary

Addresses

Primary practice location

1915 White Ave
Knoxville, TN 37916

Mailing address

1915 White Ave
Knoxville, TN 37916-2300
Phone (865) 331-1720

Other practice location 1

1915 White Ave
Knoxville, TN 37916
Phone (865) 331-1720

Other identifiers 5

IdentifierTypeStateIssuer
Q052098MedicaidTN
3770182000OtherKYPASSPORT ADVANTAGE
000000652539OtherKYANTHEM
50027640OtherKYPASSPORT
64068166MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address myers.stephen@covenanthealth.cernerdirect.com

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
I20191119000984 TN Practitioner - Hematology/Oncology 9739173089 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60120TNMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thompson Oncology Group Hematology & Oncology CurrentSince Sep 18, 2019 Accepting new patients

Locations

Dept 888078
Knoxville, TN 37995

1915 White Ave
Knoxville, TN 37916
Phone (423) 977-1065

220 Bmh Cancer Ctr
Maryville, TN 37804
Phone (865) 238-6600

Organizations & group practices 1

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1669444907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 WHITE AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162300",
            "telephone_number": "865-331-1720",
            "fax_number": "865-331-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 WHITE AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37916",
            "telephone_number": "865-331-1720",
            "fax_number": "865-331-2823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1915 White Ave",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "37916",
            "country_code": "US",
            "telephone_number": "865-331-1720",
            "fax_number": "865-331-2823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "STEPHEN",
        "middle_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "KY",
            "license": "37769",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TN",
            "license": "60120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q052098",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "3770182000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000652539",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50027640",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64068166",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "myers.stephen@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1915 White Ave",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.