NPIMap

Individual provider Active NPI

Randy Lee Denton Jr., M.D.

  • Internal Medicine Physician
  • Harriman, TN
National Provider Identifier
1851385108
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
23983 Issued in TN
Practice address
1855 Tanner Way Ste 200
Harriman, TN 37748-8331
Phone
(865) 376-6272
Fax
(865) 374-2100
NPI assigned
Sep 1, 2005
Last updated
Jun 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23983 TN Primary

Addresses

Primary practice location

1855 Tanner Way Ste 200
Harriman, TN 37748-8331

Mailing address

1855 Tanner Way Ste 200
Harriman, TN 37748-8331
Phone (865) 376-6272

Other practice location 1

408 N Roane St
Harriman, TN 37748-2057
Phone (865) 882-3745

Other identifiers 2

IdentifierTypeStateIssuer
Q066114MedicaidTN
3086338MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100909000643 TN Practitioner - Internal Medicine 4082739362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

1855 Tanner Way
Suite 220
Harriman, TN 37748-8332
Phone (865) 882-2442

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23983TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients
Covenant Medical Group, Inc CurrentSince Aug 1, 2021 Accepting new patients
W E Bennett MD Internal Medicine Past Accepting new patients

Locations

1855 Tanner Way
Ste 220
Harriman, TN 37748
Phone (865) 882-2442

408 N Roane St
Ste 100
Harriman, TN 37748
Phone (855) 882-9417

Dept 888179
Knoxville, TN 37995

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1851385108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 TANNER WAY STE 200",
            "city": "HARRIMAN",
            "state": "TN",
            "postal_code": "377488331",
            "telephone_number": "865-376-6272",
            "fax_number": "865-374-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 TANNER WAY STE 200",
            "city": "HARRIMAN",
            "state": "TN",
            "postal_code": "377488331",
            "telephone_number": "865-376-6272",
            "fax_number": "865-374-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "408 N Roane St",
            "address_purpose": "LOCATION",
            "city": "Harriman",
            "state": "TN",
            "postal_code": "377482057",
            "country_code": "US",
            "telephone_number": "865-882-3745",
            "fax_number": "865-882-6072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENTON",
        "first_name": "RANDY",
        "middle_name": "LEE",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "23983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q066114",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3086338",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harriman, TN

Sources for this page

Verify at the official NPI Registry.