NPIMap

Individual provider Active NPI

Randy Thomas Pardue, M.D.

  • Family Medicine Physician
  • Knoxville, TN
National Provider Identifier
1770539512
Registry record updated Aug 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20447 Issued in TN
Practice address
280 Fort Sanders West Blvd
Suite 101
Knoxville, TN 37922-3398
Phone
(865) 539-0270
Fax
(865) 539-6998
NPI assigned
May 25, 2006
Last updated
Aug 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20447 TN Primary

Addresses

Primary practice location

280 Fort Sanders West Blvd
Suite 101
Knoxville, TN 37922-3398

Mailing address

280 Fort Sanders West Blvd
Suite 101
Knoxville, TN 37922-3398
Phone (865) 539-0270

Other identifiers 1

IdentifierTypeStateIssuer
3052151MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110721000737 TN Practitioner - Family Practice 7416125208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Tennessee, HSC, College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

280 Fort Sanders W Blvd
Suite 101
Knoxville, TN 37922-3352
Phone (865) 539-0270

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy42
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20447TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group,PLLC Family Medicine CurrentSince Apr 1, 2020 Accepting new patients
Summit Medical Group, PLLC CurrentSince Apr 1, 2020 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Summit Medical Group, PLLC Family Medicine Past Accepting new patients

Locations

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

280 Fort Sanders West Blvd
Ste 101
Knoxville, TN 37922
Phone (865) 539-0270

Interoperability endpoints

  • Direct secure messaging: randy.pardue.1@20785.direct.athenahealth.com

Organizations & group practices 4

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 6

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344297600000",
    "number": "1770539512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 FORT SANDERS WEST BLVD",
            "address_2": "SUITE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223398",
            "telephone_number": "865-539-0270",
            "fax_number": "865-539-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 FORT SANDERS WEST BLVD",
            "address_2": "SUITE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223398",
            "telephone_number": "865-539-0270",
            "fax_number": "865-539-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARDUE",
        "first_name": "RANDY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2012-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "20447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3052151",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.