Individual provider Active NPI

Ty Taubenheim, NP

  • Nurse Practitioner
  • Oak Ridge, TN
National Provider Identifier
1902404080
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
28201 Issued in TN
Practice address
961 Oak Ridge Tpke
Oak Ridge, TN 37830-8832
Phone
(865) 690-4861
Fax
(865) 483-3807
NPI assigned
Oct 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 28201 TN Primary

Addresses

Primary practice location

961 Oak Ridge Tpke
Oak Ridge, TN 37830-8832

Mailing address

PO Box 306556
Nashville, TN 37230-6556
Phone (865) 694-0062

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201222002769 TN Practitioner - Nurse Practitioner 7719399401 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tennessee Orthopaedic Alliance PAGroup PAC ID 5193625069, 358 clinicians

Practice addresses (Care Compare)

961 Oak Ridge Tpke
Oak Ridge, TN 37830-8832
Phone (865) 483-1906

Hospital & facility affiliations

  • Methodist Medical Center of Oak Ridge Hospital, Oak Ridge, TN, CCN 440034
  • Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28201TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Orthopaedic Alliance PA CurrentSince Apr 19, 2024 Accepting new patients
Cherokee Health Systems CurrentSince Nov 30, 2020 Accepting new patients
Tennessee Orthopaedic Alliance PA CurrentSince Apr 19, 2024 Accepting new patients
Cherokee Health Systems CurrentSince Nov 30, 2020 Accepting new patients
Tennessee Orthopaedic Alliance PA Past Accepting new patients

Locations

9430 Park West Blvd
Ste 130
Knoxville, TN 37923
Phone (865) 694-8353

2018 Western Ave
Knoxville, TN 37921
Phone (865) 544-0406

6484 Kingston Pike
Knoxville, TN 37919
Phone (865) 633-0235

538 W 5th Ave
Knoxville, TN 37917
Phone (865) 525-2104

4882 Harvest Mill Way
Knoxville, TN 37918
Phone (865) 560-8550

1923 Sulphur Springs Rd
Morristown, TN 37813

8 City Blvd
Ste 100
Nashville, TN 37209
Phone (615) 263-0155

988 Oak Ridge Tpke
Ste 100
Oak Ridge, TN 37830
Phone (865) 483-8478

961 Oak Ridge Tpke
Oak Ridge, TN 37830
Phone (865) 483-1906

1679 Veterans Blvd
Sevierville, TN 37862
Phone (865) 401-9062

6350 W Andrew Johnson Hwy
#100
Talbott, TN 37877
Phone (423) 586-5031

Interoperability endpoints

  • Direct secure messaging: ty.taubenheim.p2@direct.toa.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1902404080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306556",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306556",
            "telephone_number": "865-694-0062",
            "fax_number": "865-694-7907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 OAK RIDGE TPKE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378308832",
            "telephone_number": "865-690-4861",
            "fax_number": "865-483-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUBENHEIM",
        "first_name": "TY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-12",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "28201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.