Individual provider Active NPI

Grant Michael Clark, M.D.

  • Radiation Oncology Physician
  • Knoxville, TN
National Provider Identifier
1700029626
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
51020 Issued in TN
Practice address
1915 White Avenue
Knoxville, TN 37916-2399
Phone
(865) 331-1155
Fax
(865) 331-3165
NPI assigned
Apr 7, 2009
Last updated
May 18, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 51020 TN Primary

Addresses

Primary practice location

1915 White Avenue
Knoxville, TN 37916-2399

Mailing address

PO Box 24120
Knoxville, TN 37933-2120
Phone (865) 803-4321

Other identifiers 1

IdentifierTypeStateIssuer
Q005973MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clark.grant.michael@covenanthealth.cernerdirect.com Direct

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
I20140624002493 TN Practitioner - Radiation Oncology 1052557725 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
West Virginia University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Tennessee Radiation Oncology, P.C.Group PAC ID 6103917729, 8 clinicians

Practice addresses (Care Compare)

1915 White Ave
Knoxville, TN 37916-2300
Phone (865) 541-1155

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Radiation Oncology, P.C. Radiation Oncology CurrentSince Jun 1, 2014 Accepting new patients

Locations

421 S Main St
Crossville, TN 38555
Phone (931) 260-1465

Knoxville, TN 37995

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

6450 Provision Cares Way
Knoxville, TN 37909
Phone (865) 342-4518

9711 Sherrill Blvd
Knoxville, TN 37932
Phone (865) 373-5000

Dept 888027
Knoxville, TN 37995

908 W 4th North St
Morristown, TN 37814
Phone (423) 492-9000

710 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 446-9025

Interoperability endpoints

  • Direct secure messaging: clark.grant.michael@covenanthealth.cernerdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1239062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1700029626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24120",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379332120",
            "telephone_number": "865-803-4321",
            "fax_number": "865-988-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 WHITE AVENUE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162399",
            "telephone_number": "865-331-1155",
            "fax_number": "865-331-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GRANT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-07",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TN",
            "license": "51020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q005973",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clark.grant.michael@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1915 White Avenue",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379162399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.