NPIMap

Individual provider Active NPI

Roger Dale Gaddis, DO

  • Family Medicine Physician
  • Alcoa, TN
National Provider Identifier
1902009699
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO0000001730 Issued in TN
Practice address
266 Joule St
Alcoa, TN 37701-2422
Phone
(865) 984-3864
Fax
(865) 380-4095
NPI assigned
Jun 8, 2007
Last updated
Jan 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO0000001730 TN Primary

Addresses

Primary practice location

266 Joule St
Alcoa, TN 37701-2422

Mailing address

701 Morganton Square Dr
Maryville, TN 37801-4796
Phone (865) 273-1752

Other identifiers 2

IdentifierTypeStateIssuer
4334952MedicaidTN
1513698MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.77 of 100Reported as group
Quality
58.61
Promoting interoperability
92
Improvement activities
40
Cost
73.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO0000001730TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage Services, PC Past Accepting new patients
Holistic Family Care Family Medicine PastSince Oct 21, 2010 Accepting new patients
Uhs Ventures PastSince Jul 24, 2022 Accepting new patients
Tennessee Preferred Medical, LLC PastSince Nov 14, 2012 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Emergency Coverage, LLC Family Medicine Past Accepting new patients
Occupational Alternative and Rehabilitative Services, PC Past Accepting new patients
Southern Rehabilitation Group, PLLC Past Accepting new patients
Appalachian Medical Services LLC Past Accepting new patients
East Tennessee Medical Group, PC Family Medicine Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACJDDD/Endpoint/ACJDDD

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1902009699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MORGANTON SQUARE DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014796",
            "telephone_number": "865-273-1752",
            "fax_number": "865-273-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 JOULE ST",
            "city": "ALCOA",
            "state": "TN",
            "postal_code": "377012422",
            "telephone_number": "865-984-3864",
            "fax_number": "865-380-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDIS",
        "first_name": "ROGER",
        "middle_name": "DALE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-08",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "DO0000001730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4334952",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1513698",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alcoa, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.