Covenant Medical Group, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

COVENANT MEDICAL GROUP, INC

Practice address

2210 Sutherland Ave Ste 110
Knoxville, TN 37919-2337

Phone

(865) 525-4333

Fax

(865) 212-8879

NPI assigned

Aug 23, 2021

Last updated

Aug 23, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Julie Utterback

Title

Chief Financial Officer

Phone

(865) 374-5119

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Alcoa, TN
  • NPI 1093312415

  2860305463

  Same PAC ID
• Covenant Medical Group, Inc

  • Urology Physician
  • Knoxville, TN
  • NPI 1386241859

  2860305463

  Same PAC ID
• Covenant Medical Group, Inc

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1881636488

  2860305463

  Same PAC ID
• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010

  2860305463

  Same PAC ID

Tax ID family

Covenant Med MNG Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Alcoa, TN
  • NPI 1093312415
  NPD tax ID
• Covenant Medical Group, Inc

  • Urology Physician
  • Knoxville, TN
  • NPI 1386241859
  NPD tax ID
• Covenant Medical Group, Inc

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1881636488
  NPD tax ID
• Internal Medicince West a Member of Covenant Health

  • Internal Medicine Physician
  • Knoxville, TN
  • NPI 1922138262
  NPD tax ID

Locations (25 of 35)

Practitioners 549

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.

• Wahid John Abadier, MD

  • Surgery Physician
  • Lenoir City, TN
  • NPI 1144391657
  NPD
• Bassem A Abazid, M.D.

  • Cardiovascular Disease Physician
  • Lenoir City, TN
  • NPI 1689835944
  NPD
• Ahmed Kassem Selim Abdallah, M.D

  • Cardiovascular Disease Physician
  • Lenoir City, TN
  • NPI 1124525597
  NPD
• Elias Abou-Zeid, MD

  • Neurology Physician
  • Crossville, TN
  • NPI 1659572873
  NPD
• Cathy Denise Abston, NP-C

  • Family Nurse Practitioner
  • Harriman, TN
  • NPI 1992172779
  NPD
• Ahmad Adel Taha Abu-Heija, M.D.

  • Gastroenterology Physician
  • Oak Ridge, TN
  • NPI 1134574072
  NPD
• Joanna Grace Adams, NP

  • Nurse Practitioner
  • Knoxville, TN
  • NPI 1013353176
  NPD
• John Stewart Adams, M.D.

  • Infectious Disease Physician
  • Knoxville, TN
  • NPI 1578542338
  NPD
• Rasmi Ajit, MD

  • Internal Medicine Physician
  • Knoxville, TN
  • NPI 1003202540
  NPD
• Jeffrey R Albea, MD

  • Neurological Surgery Physician
  • Knoxville, TN
  • NPI 1548259906
  NPD
• Charles Joseph Allderdice, M.D.

  • Interventional Cardiology Physician
  • Knoxville, TN
  • NPI 1104262096
  NPD
• James Stephen Alley, MD

  • Internal Medicine Physician
  • Knoxville, TN
  • NPI 1295780369
  NPD

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1871269415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 SUTHERLAND AVE STE 110",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379192337",
            "telephone_number": "865-525-4333",
            "fax_number": "865-212-8879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 SUTHERLAND AVE STE 110",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379192337",
            "telephone_number": "865-525-4333",
            "fax_number": "865-212-8879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "UTTERBACK",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "865-374-5119"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Covenant Homecare (Covenant Palliative Care)
• Covenant Homecare (Covenant Home Medical Equipment)
• Covenant Homecare
• Covenant Medical Group, Inc
• Covenant Medical Group, Inc
• Covenant Medical Group, Inc
• Covenant Medical Group, Inc.
• Tracy Coverdale, CRNA
• Jamie Lee Covington, R.N.
• Kelli Covington, MA, CCC-SLP

• Durable Medical Equipment & Medical Supplies in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.