Individual provider Active NPI

Kimberly A. Goodemote, M.D.

  • Hospitalist Physician
  • Maryville, TN
National Provider Identifier
1902919293
Registry record updated May 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
35307 Issued in TN
Practice address
907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015
Phone
(865) 980-4897
Fax
(865) 977-4796
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2017

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 35307 TN
Hospitalist Physician 208M00000X 35307 TN Primary

Addresses

Primary practice location

907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015

Mailing address

103 W Broadway Ave
Maryville, TN 37801-4703
Phone (865) 273-1752

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
I20070806000436 TN Practitioner - Family Practice 7618068610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Georgetown University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blount Memorial Physician Group IncGroup PAC ID 6406844174, 252 clinicians

Practice addresses (Care Compare)

907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015
Phone (865) 980-5082

Hospital & facility affiliations

  • Blount Memorial Hospital Hospital, Maryville, TN, CCN 440011

Merit-based Incentive Payment System (MIPS)

Final score
81.56 of 100Reported as apm
Quality
52.91
Promoting interoperability
100
Improvement activities
40

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 Medicine

State licenses

LicenseStateTypeSpecialty
35307TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Aug 14, 2012 Accepting new patients
Blount Memorial Physician Group, Inc Family Medicine CurrentSince Apr 1, 2017 Accepting new patients
Fast Pace Medical Clinic PLLC Family Medicine CurrentSince Aug 14, 2012 Accepting new patients
Prisma Health - Blount Memorial Hospital Inc. Past Accepting new patients
Southeastern Physician Services PC Hospitalist Past Accepting new patients

Locations

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

463 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5100

250 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5244

458 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5355

103 W Broadway Ave
Maryville, TN 37801

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kgoodemote864378@direct.ghs.myhfn.org

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 1

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1902919293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W BROADWAY AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014703",
            "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": "907 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045015",
            "telephone_number": "865-980-4897",
            "fax_number": "865-977-4796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODEMOTE",
        "first_name": "KIMBERLY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "35307",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "35307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.