Individual provider Active NPI

Larry T Justice, M.D.

  • Cardiovascular Disease Physician
  • Oak Ridge, TN
National Provider Identifier
1790721819
Registry record updated Sep 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
40574 Issued in TN
Practice address
80 Vermont Ave
Oak Ridge, TN 37830-6474
Phone
(865) 482-4078
Fax
(865) 482-4960
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 40574 TN
Cardiovascular Disease Physician 207RC0000X 40574 TN Primary

Addresses

Primary practice location

80 Vermont Ave
Oak Ridge, TN 37830-6474

Mailing address

80 Vermont Ave
Oak Ridge, TN 37830-6474
Phone (865) 482-4078

Other identifiers 5

IdentifierTypeStateIssuer
3338151MedicaidTN
4125100OtherTNBCBST
7100065540OtherKYMEDICAID
Q009959MedicaidTN
3379860MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address justice.larry@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
I20060621000210 TN Practitioner - Cardiovascular Disease (Cardiology) 5991717605 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Kentucky College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cumberland Medical Center, Inc.Group PAC ID 3870401441, 9 clinicians
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians
Roane County Medical CenterGroup PAC ID 8921167545, 7 clinicians
Methodist Medical CenterGroup PAC ID 7012812860, 7 clinicians

Practice addresses (Care Compare)

421 S Main St
Crossville, TN 38555-5048
Phone (931) 484-9511

80 Vermont Ave
Oak Ridge, TN 37830-6474
Phone (865) 482-4078

8045 Roane Medical Ctr Dr
Harriman, TN 37748-8333
Phone (865) 316-1000

990 Oak Ridge Tpke
Oak Ridge, TN 37830-6976
Phone (865) 481-1000

Hospital & facility affiliations

  • Methodist Medical Center of Oak Ridge Hospital, Oak Ridge, TN, CCN 440034
  • Roane Medical Center Hospital, Harriman, TN, CCN 440031
  • Cumberland Medical Center Hospital, Crossville, TN, CCN 440009
  • Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173

Merit-based Incentive Payment System (MIPS)

Final score
93.86 of 100Reported as individual
Quality
84.82
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting16
Pacemaker insertion or repair21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Roane County Medical Center Current Accepting new patients
Fort Sanders Regional Medical Center CurrentSince Feb 1, 2023 Accepting new patients
Covenant Medical Group, Inc CurrentSince Aug 1, 2020 Accepting new patients
Covenant Medical Group, Inc. Cardiovascular Disease CurrentSince Aug 1, 2020 Accepting new patients
Cumberland Medical Center, Inc. CurrentSince Aug 1, 2024 Accepting new patients
RDT Enterprises Inc. PastSince Feb 5, 2011 Accepting new patients
Temecula Valley Physical Therapy Past Accepting new patients

Locations

421 S Main St
Crossville, TN 38555
Phone (931) 260-1465

Dept 888179
Knoxville, TN 37995

1901 Clinch Ave
Knoxville, TN 37916
Phone (865) 331-1111

Dept 888001
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

990 Oak Ridge Tpke
Oak Ridge, TN 37830
Phone (865) 481-1000

80 Vermont Ave
Oak Ridge, TN 37830
Phone (423) 482-4078

Interoperability endpoints

  • Direct secure messaging: justice.larry@covenanthealth.cernerdirect.com

Organizations & group practices 8

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 4

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1790721819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 VERMONT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306474",
            "telephone_number": "865-482-4078",
            "fax_number": "865-482-4960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 VERMONT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306474",
            "telephone_number": "865-482-4078",
            "fax_number": "865-482-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "LARRY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TN",
            "license": "40574",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "40574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3338151",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "4125100",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KYMEDICAID",
            "identifier": "7100065540",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q009959",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3379860",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "justice.larry@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "80 Vermont Ave",
            "city": "Oak Ridge",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378306474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.