Walter M Novikoff, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1562 Issued in TN

Practice address

1503 E Lamar Alexander Pkwy
Maryville, TN 37804-5131

Phone

(865) 980-5290

Fax

(865) 980-5295

NPI assigned

Nov 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

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.

• East Tennessee Medical Group, PC

  • Family Medicine Physician
  • Alcoa, TN
  • NPI 1942238902
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1801974225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W BROADWAY AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014703",
            "telephone_number": "865-273-1752",
            "fax_number": "865-273-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045131",
            "telephone_number": "865-980-5290",
            "fax_number": "865-980-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVIKOFF",
        "first_name": "WALTER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "1562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3907948",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Marie Norfleet, LPTA
• Kimberly C. Norman, D.D.S.
• Elissa Norris-Rose, CCC-SLP
• North Star Counseling and Wellness Center
• Steve Noutong Njapo, M.D
• Joyce Michelle Nuchols, RN
• Susan M Nuchols, RN
• Nurturing Beginnings Lactation Services, LLC
• Chinonyelum Doris Nwagbara, MD
• Kenechukwu Nwagbara, M.D.

• Family Medicine Physician in Maryville, TN
• Providers in Maryville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.