Individual provider Active NPI

Michael L Maggart, M.D.

  • Vascular Surgery Physician
  • Knoxville, TN
National Provider Identifier
1770566176
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD0000014758 Issued in TN
Practice address
101 E Blount Ave
Suite 800
Knoxville, TN 37920-1632
Phone
(865) 632-5900
Fax
(865) 637-2114
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X MD0000014758 TN Primary

Addresses

Primary practice location

101 E Blount Ave
Suite 800
Knoxville, TN 37920-1632

Mailing address

101 E Blount Ave
Suite 800
Knoxville, TN 37920-1632
Phone (865) 632-5900

Other identifiers 2

IdentifierTypeStateIssuer
52220OtherTNBLUE CROSS BLUE SHIELD
3378302MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address maggart.michael@covenanthealth.cernerdirect.com

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
I20111215000170 TN Practitioner - Cardiac SurgeryPractitioner - Thoracic Surgery 7214095819 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery
Education
Vanderbilt University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Tennessee Cardiovascular Surgery Group PCGroup PAC ID 6608934203, 20 clinicians

Practice addresses (Care Compare)

9330 Park W Blvd
Suite 100
Knoxville, TN 37923-4309
Phone (865) 632-5900

Hospital & facility affiliations

  • Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000014758TNMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Cardiovascular Surgery Group, P.C CurrentSince Jul 11, 1985 Accepting new patients

Locations

9330 Park West Blvd
Ste 100
Knoxville, TN 37923
Phone (865) 373-7942

Dept 888101
Knoxville, TN 37995

9125 Cross Park Dr
Ste 200
Knoxville, TN 37923
Phone (865) 632-5900

101 E Blount Ave
Ste 800
Knoxville, TN 37920
Phone (865) 632-5900

501 19th St
Ste 309
Knoxville, TN 37916
Phone (865) 541-1810

Interoperability endpoints

  • Direct secure messaging: maggart.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1770566176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E BLOUNT AVE",
            "address_2": "SUITE 800",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201632",
            "telephone_number": "865-632-5900",
            "fax_number": "865-637-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E BLOUNT AVE",
            "address_2": "SUITE 800",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201632",
            "telephone_number": "865-632-5900",
            "fax_number": "865-637-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGGART",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "MD0000014758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "52220",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3378302",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "maggart.michael@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "101 E Blount Ave",
            "address_2": "Suite 800",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379201632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.