Individual provider Active NPI

Russel W Rhea III, M.D.

  • Specialist
  • Knoxville, TN
National Provider Identifier
1841386984
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
24373 Issued in TN
Practice address
125 Huxley Road
Knoxville, TN 37922
Phone
(865) 691-3335
Fax
(865) 691-3310
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 24373 TN Primary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 24373 TN

Addresses

Primary practice location

125 Huxley Road
Knoxville, TN 37922

Mailing address

125 Huxley Road
Knoxville, TN 37922
Phone (865) 691-3335

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
I20050811001076 TN Practitioner - Pediatric Medicine 7214966969 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24373TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cookeville Regional Medical Center Single Specialty CurrentSince Dec 1, 2016 Accepting new patients
DX Mso, PLLC Single Specialty CurrentSince Mar 5, 2017 Accepting new patients
Cookeville Regional Medical Center CurrentSince Dec 1, 2016 Accepting new patients
Methodist Medical Center Single Specialty Past Accepting new patients
University Health System Inc Past Accepting new patients

Locations

700 E 54th St N
Sioux Falls, SD 57104
Phone (423) 458-1426

1025 Peerless Xing NW
Cleveland, TN 37312
Phone (423) 476-5990

170 Mouse Creek Rd NW
Cleveland, TN 37312
Phone (423) 458-1426

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1841386984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 HUXLEY ROAD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37922",
            "telephone_number": "865-691-3335",
            "fax_number": "865-691-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 HUXLEY ROAD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37922",
            "telephone_number": "865-691-3335",
            "fax_number": "865-691-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHEA",
        "first_name": "RUSSEL",
        "middle_name": "W",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "24373",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "24373",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.