Individual provider Active NPI

Laura Purdom, M.D.

  • Family Medicine Physician
  • Dandridge, TN
National Provider Identifier
1821282997
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41555 Issued in TN
Practice address
150 W Price Rd
Dandridge, TN 37725-4524
Phone
(865) 475-6161
Fax
(865) 475-9857
NPI assigned
Aug 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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 41555 TN Primary

Addresses

Primary practice location

150 W Price Rd
Dandridge, TN 37725-4524

Mailing address

150 W Price Rd
Dandridge, TN 37725-4524
Phone (865) 475-6161

Other identifiers 1

IdentifierTypeStateIssuer
1507375MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address laura.purdom.1@3525.direct.athenahealth.com Direct

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
I20080904000357 TN Practitioner - Family Practice 8123194875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
East Tennessee State University Quillen College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthstar Physicians PCGroup PAC ID 5890690978, 89 clinicians

Practice addresses (Care Compare)

420 W Morris Blvd
Morristown, TN 37813-2282

420 W Morris Blvd
Suite 400H
Morristown, TN 37813-2283
Phone (423) 586-4545

657 E Broadway Blvd
Suite a
Jefferson City, TN 37760-4949
Phone (865) 475-9062

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41555TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthstar Physicians PC CurrentSince Sep 1, 2008 Accepting new patients
Healthstar Physicians, P.C. Family Medicine CurrentSince Sep 1, 2008 Accepting new patients
East Tennessee Primary Care Associates Family Medicine Past Accepting new patients

Locations

150 W Price Rd
Dandridge, TN 37725
Phone (865) 475-6161

657 E Broadway Blvd
Ste C
Jefferson Cty, TN 37760
Phone (423) 586-1717

420 W Morris Blvd
Ste 400C
Morristown, TN 37813
Phone (423) 586-0443

5741 W Andrew Johnson Hwy
Morristown, TN 37814
Phone (423) 585-0686

Organizations & group practices 3

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 3

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": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1821282997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W PRICE RD",
            "city": "DANDRIDGE",
            "state": "TN",
            "postal_code": "377254524",
            "telephone_number": "865-475-6161",
            "fax_number": "865-475-9857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W PRICE RD",
            "city": "DANDRIDGE",
            "state": "TN",
            "postal_code": "377254524",
            "telephone_number": "865-475-6161",
            "fax_number": "865-475-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURDOM",
        "first_name": "LAURA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-31",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "41555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1507375",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "laura.purdom.1@3525.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "150 W Price Rd",
            "city": "Dandridge",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377254524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dandridge, TN

Sources for this page

Verify at the official NPI Registry.