Knoxville Dermatology Group PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

KNOXVILLE DERMATOLOGY GROUP PC

Practice address

123 Fox Rd
Knoxville, TN 37922-3369

Phone

(865) 690-9467

Fax

(865) 381-6287

NPI assigned

Jun 26, 2006

Last updated

Jun 13, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angela Peterman, MD

Title

Owner

Phone

(865) 690-9467

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 40

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.

• Sheri L Chapman, FNP

  • Nurse Practitioner
  • Sevierville, TN
  • NPI 1902321359
  Medicare reassignment Care Compare group NPD
• Elizabeth Noble Ergen, M.D.

  • Dermatology Physician
  • Nashville, TN
  • NPI 1821350521
  Medicare reassignment Care Compare group NPD
• Robert Milton Gathings III, M.D.

  • MOHS-Micrographic Surgery Physician
  • Knoxville, TN
  • NPI 1548671928

  Dermatology

  Medicare reassignment Care Compare group NPD
• Misty Dawn Hammond, FNP

  • Nurse Practitioner
  • Powell, TN
  • NPI 1477919520
  Medicare reassignment Care Compare group NPD
• Matthew C Hanggi, MD

  • MOHS-Micrographic Surgery Physician
  • Knoxville, TN
  • NPI 1043278336

  Dermatology

  Medicare reassignment Care Compare group NPD
• Constance L Hayes, DNP, APRNC, FNP-C

  • Nurse Practitioner
  • Alcoa, TN
  • NPI 1174660971
  Medicare reassignment Care Compare group NPD
• Melissa F. Headrick, ANP-BC

  • Nurse Practitioner
  • Powell, TN
  • NPI 1568600062
  Medicare reassignment Care Compare group NPD
• Drew Wilson Miller, M.D.

  • MOHS-Micrographic Surgery Physician
  • Knoxville, TN
  • NPI 1033398532

  Dermatology

  Medicare reassignment Care Compare group NPD
• Edward John Primka III, M.D.

  • Dermatology Physician
  • Knoxville, TN
  • NPI 1134105919
  Medicare reassignment Care Compare group NPD
• Whitney Stone Sharp, NP

  • Nurse Practitioner
  • Knoxville, TN
  • NPI 1952017139
  Medicare reassignment Care Compare group NPD
• Angela H. Smith, FNP

  • Nurse Practitioner
  • Knoxville, TN
  • NPI 1427036607
  Medicare reassignment Care Compare group NPD
• Sandra Vaughn, NP

  • Nurse Practitioner
  • Knoxville, TN
  • NPI 1073693206

  Dermatology

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686614400000",
    "number": "1760419014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 FOX RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223369",
            "telephone_number": "865-690-9467",
            "fax_number": "865-381-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 FOX RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223369",
            "telephone_number": "865-690-9467",
            "fax_number": "865-381-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOXVILLE DERMATOLOGY GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "PETERMAN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-690-9467",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Knoxville Dental, PC (TLC Dental Care)
• Knoxville Dentistry Group PLLC
• Knoxville Dermatology Group PC
• Knoxville Dermatology Group PC
• Knoxville Dermatology Group PC
• Knoxville Dietitian Services
• Knoxville Emergency Physicians Group PC
• Knoxville Endocrinology Clinic, LLC
• Knoxville Eye Anesthesia LLC
• Knoxville Eye Care Center

• Dermatology Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Dermatology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.