NPIMap

Organization Active NPI

Tennessee Cancer Specialists PLLC

Doing business as Tennessee Cancer Specialists Pharmacy

  • Community/Retail Pharmacy
  • Knoxville, TN
National Provider Identifier
1760717896
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
4721 Issued in TN
Legal business name
TENNESSEE CANCER SPECIALISTS PLLC
Doing business as
Tennessee Cancer Specialists Pharmacy
Practice address
1415 Old Weisgarber Rd Ste 200
Knoxville, TN 37909-1341
Phone
(865) 934-5806
Fax
(865) 934-5816
NPI assigned
Oct 7, 2009
Last updated
Jun 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Authorized official

Name
Mitchell Martin, MDNPI 1639179708
Title
Chief Manager Physician
Phone
(865) 637-9330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 4721 TN Primary

Addresses

Primary practice location

1415 Old Weisgarber Rd Ste 200
Knoxville, TN 37909-1341

Mailing address

900 E Hill Ave
Suite 230
Knoxville, TN 37915-2566
Phone (865) 862-0998

Other identifiers 1

IdentifierTypeStateIssuer
2122184OtherPK

Other names 1

  • Tennessee Cancer Specialists Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040702000160 TN Part B Supplier - Clinic/Group Practice 1658358171 Receives reassigned benefits from 69 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jefferson City, TN; Sweetwater, TN; Powell, TN; Oak Ridge, TN; Newport, TN; La Follette, TN; Knoxville, TN; Athens, TN…

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Tennessee Cancer Spec66 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466467200000",
    "number": "1760717896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E HILL AVE",
            "address_2": "SUITE 230",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379152566",
            "telephone_number": "865-862-0998",
            "fax_number": "865-544-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 OLD WEISGARBER RD STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091341",
            "telephone_number": "865-934-5806",
            "fax_number": "865-934-5816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE CANCER SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-07",
        "last_updated": "2016-06-21",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_title_or_position": "CHIEF MANAGER PHYSICIAN",
        "authorized_official_telephone_number": "865-637-9330",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "4721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2122184",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tennessee Cancer Specialists Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.