Paul Carl Peterson, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

MD0000027743 Issued in TN

Practice address

501 20TH St
Suite 503
Knoxville, TN 37916-1809

Phone

(865) 541-4321

Fax

(865) 541-4320

NPI assigned

Sep 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Neurosurgery

Education

Wayne State University School of Medicine, 1990

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)

Hospital & facility affiliations

• Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125
• Morristown Hamblen Hospital Association Hospital, Morristown, TN, CCN 440030

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: peterson.paul@covenanthealth.cernerdirect.com

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.

• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010

  Neurological Surgery

  Medicare reassignment Care Compare group NPD
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1871269415
  NPD
• Fort Sanders Regional Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1942294814
  NPD (past)
• Neurosurgery Clinic of Knoxville, PLLC

  • Neurological Surgery Physician
  • Knoxville, TN
  • NPI 1841411204
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fort Sanders Regional Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1942294814
  Care Compare affiliation
• Morristown Hamblen Hospital Association

  • General Acute Care Hospital
  • Morristown, TN
  • NPI 1912997024
  Care Compare affiliation

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1891780862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 20TH ST",
            "address_2": "SUITE 503",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37916",
            "telephone_number": "865-541-4321",
            "fax_number": "865-541-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 20TH ST",
            "address_2": "SUITE 503",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161809",
            "telephone_number": "865-541-4321",
            "fax_number": "865-541-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "PAUL",
        "middle_name": "CARL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TN",
            "license": "MD0000027743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3099553",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "peterson.paul@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "501 20th St",
            "address_2": "Suite 503",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379161809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Franya McLaughlin Peterson, D.C.
• Glenn R Peterson, MD
• Jennifer Renee Peterson, MSN, APRN, FNP-C
• Katherine Peterson
• Matthew Peterson, B.A.
• Rachel Peterson, LCSW
• Sabrina Jeanne Peterson, LPC
• Susan Morgan Peterson, LPN
• Regina R Pethel, CRNA
• Ayrias Petitt

• Neurological Surgery Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Neurological Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.