Individual provider Active NPI

Ryan Semko, D.O.

  • Family Medicine Physician
  • Oak Ridge, TN
National Provider Identifier
1881129443
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4042 Issued in TN
Practice address
100 Vermont Ave
Oak Ridge, TN 37830-6471
Phone
(865) 482-1777
NPI assigned
Apr 20, 2017
Last updated
Apr 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OT017598 PA
Family Medicine Physician 207Q00000X 4042 TN Primary

Addresses

Primary practice location

100 Vermont Ave
Oak Ridge, TN 37830-6471

Mailing address

100 Vermont Ave
Oak Ridge, TN 37830-6471
Phone (865) 482-1777

Other practice location 1

1 Mellon Way
Latrobe, PA 15650-1197
Phone (724) 537-1207

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address semko.ryan.george@covenanthealth.cernerdirect.com

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
I20200824003391 TN Practitioner - Family Practice 1052681251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2017
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)

100 Vermont Ave
Oak Ridge, TN 37830-6471
Phone (865) 482-1777

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions12
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT017598PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. Family Medicine CurrentSince Aug 31, 2020 Accepting new patients
Covenant Medical Group, Inc CurrentSince Aug 31, 2020 Accepting new patients

Locations

Dept 888179
Knoxville, TN 37995

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

100 Vermont Ave
Oak Ridge, TN 37830
Phone (865) 482-1777

Interoperability endpoints

  • Direct secure messaging: semko.ryan.george@covenanthealth.cernerdirect.com

Organizations & group practices 2

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 4

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": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1881129443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VERMONT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306471",
            "telephone_number": "865-482-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VERMONT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306471",
            "telephone_number": "865-482-1777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Mellon Way",
            "address_purpose": "LOCATION",
            "city": "Latrobe",
            "state": "PA",
            "postal_code": "156501197",
            "country_code": "US",
            "telephone_number": "724-537-1207",
            "fax_number": "724-537-1635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEMKO",
        "first_name": "RYAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-20",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT017598",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "4042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "semko.ryan.george@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "100 Vermont Ave",
            "city": "Oak Ridge",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378306471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.