Charles G Sewall, M.D.

Primary specialty

Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X

License

021441 Issued in TN

Practice address

800 Oak Ridge Tpke
Suite C-100
Oak Ridge, TN 37830-6957

Phone

(865) 483-2288

Fax

(865) 482-4400

NPI assigned

Aug 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1125187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1750374476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 OAK RIDGE TPKE",
            "address_2": "SUITE C-100",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306957",
            "telephone_number": "865-483-2288",
            "fax_number": "865-482-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 OAK RIDGE TPKE",
            "address_2": "SUITE C-100",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306957",
            "telephone_number": "865-483-2288",
            "fax_number": "865-482-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1855 Tanner Way Ste 130",
            "address_purpose": "LOCATION",
            "city": "Harriman",
            "state": "TN",
            "postal_code": "377488331",
            "country_code": "US",
            "telephone_number": "865-882-1600",
            "fax_number": "865-285-9684",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "49 Cleveland St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Crossville",
            "state": "TN",
            "postal_code": "385552854",
            "country_code": "US",
            "telephone_number": "931-456-1550",
            "fax_number": "931-456-1555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 Independence Ln Ste 500",
            "address_purpose": "LOCATION",
            "city": "LA Follette",
            "state": "TN",
            "postal_code": "377663040",
            "country_code": "US",
            "telephone_number": "423-562-9744",
            "fax_number": "865-544-1862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEWALL",
        "first_name": "CHARLES",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-28",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "KY",
            "license": "28475",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "TN",
            "license": "021441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC RIVER VALLEY",
            "identifier": "62089728903",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000252844",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP TENNCARE",
            "identifier": "100020676",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3059927",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUEGRASS",
            "identifier": "620897289002",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4666257",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CUMBERLAND HEALTHCARE",
            "identifier": "C10003",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64799125",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3028800",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHA",
            "identifier": "4532",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Plastic Surgery within the Head & Neck (Otolaryngology) Physician in Oak Ridge, TN
• Providers in Oak Ridge, TN by specialty
• Plastic Surgery within the Head & Neck (Otolaryngology) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.