NPIMap

Organization Active NPI

Allergy & Asthma Affiliates, PC

  • Allergy & Immunology Physician
  • Oak Ridge, TN
National Provider Identifier
1851673735
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
ALLERGY & ASTHMA AFFILIATES, PC
Practice address
1060 Oak Ridge Turnpike
Oak Ridge, TN 37830-6439
Phone
(865) 525-2640
Fax
(865) 525-9536
NPI assigned
Sep 15, 2011
Last updated
Sep 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Authorized official

Name
Dr. Donald Trent Ellenburg, M.D.NPI 1548354475
Title
Managing Partner
Phone
(865) 525-2640

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

1060 Oak Ridge Turnpike
Oak Ridge, TN 37830-6439

Mailing address

2121 Highland Ave
Knoxville, TN 37916-1111
Phone (865) 525-2640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040819001511 TN Part B Supplier - Clinic/Group Practice 7012981772 Receives reassigned benefits from 10 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alcoa, TN; Sevierville, TN; Powell, TN; Oak Ridge, TN; Morristown, TN; Knoxville, TN; Farragut, TN

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2038989Allergy & Asthma Affiliates1060 Oak Ridge Turnpike, Oak Ridge, TN 37830Certificate of waiverMar 28, 2028

National Provider Directory

National Provider Directory
Tax ID family
Regional Children's9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1851673735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 HIGHLAND AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161111",
            "telephone_number": "865-525-2640",
            "fax_number": "865-525-9536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 OAK RIDGE TURNPIKE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306439",
            "telephone_number": "865-525-2640",
            "fax_number": "865-525-9536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY & ASTHMA AFFILIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-15",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "ELLENBURG",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "TRENT",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "865-525-2640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.