Individual provider Active NPI

David W Drum, PA-C

  • Physician Assistant
  • Oak Ridge, TN
National Provider Identifier
1942286935
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0168 Issued in TN
Practice address
160A W Tennessee Ave
Oak Ridge, TN 37830-6501
Phone
(865) 835-3740
Fax
(865) 835-3742
NPI assigned
Dec 21, 2005
Last updated
Oct 29, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA0168 TN Primary

Addresses

Primary practice location

160A W Tennessee Ave
Oak Ridge, TN 37830-6501

Mailing address

988 Oak Ridge Tpke Ste L40
Oak Ridge, TN 37830-6940
Phone (865) 482-4028

Other identifiers 1

IdentifierTypeStateIssuer
1508048MedicaidTN

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
I20041123000156 TN Practitioner - Physician Assistant 0042275604 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Vascular, PLLCGroup PAC ID 9335523802, 5 clinicians

Practice addresses (Care Compare)

1108 Fox Meadows Blvd
Suite 2
Sevierville, TN 37862-6939
Phone (865) 562-3232

460 Medical Park Dr
Suite 104
Lenoir City, TN 37772-5782
Phone (865) 562-3232

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0168TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Vascular Outpatient Center PastSince Feb 11, 2024 Accepting new patients
Vascular Diagnostic Center of Oak Ridge Inc PastSince Oct 27, 2019 Accepting new patients
Physicians Diagnostic Services PastSince Oct 27, 2019 Accepting new patients

Organizations & group practices 7

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 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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1942286935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 OAK RIDGE TPKE STE L40",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306940",
            "telephone_number": "865-482-4028",
            "fax_number": "865-835-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160A W TENNESSEE AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306501",
            "telephone_number": "865-835-3740",
            "fax_number": "865-835-3742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRUM",
        "first_name": "DAVID",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA0168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508048",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.