Individual provider Active NPI

William Vinh Ngo, D.O.

  • Vascular Surgery Physician
  • Sevierville, TN
National Provider Identifier
1962700070
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
2978 Issued in TN
Practice address
744 Middle Creek Rd
Suite 210
Sevierville, TN 37862-5015
Phone
(865) 446-9550
NPI assigned
Mar 14, 2011
Last updated
Jun 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 2978 TN Primary

Addresses

Primary practice location

744 Middle Creek Rd
Suite 210
Sevierville, TN 37862-5015

Mailing address

744 Middle Creek Rd
Suite 210
Sevierville, TN 37862-5015
Phone (865) 446-9550

Other identifiers 1

IdentifierTypeStateIssuer
Q021873MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Ngo.William@covenanthealth.cernerdirect.com

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
I20160803002344 TN Practitioner - General Surgery 2264664671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2016
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)

111 Clyde St
Loudon, TN 37774-1600
Phone (865) 458-1554

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2978TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Covenant Medical Group, Inc CurrentSince Aug 1, 2016 Accepting new patients

Locations

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

744 Middle Creek Rd
Ste 210
Sevierville, TN 37862
Phone (865) 446-9550

Interoperability endpoints

  • Direct secure messaging: ngo.william@covenanthealth.cernerdirect.com

Organizations & group practices 2

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 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": "1300060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1962700070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 MIDDLE CREEK RD",
            "address_2": "SUITE 210",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378625015",
            "telephone_number": "865-446-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 MIDDLE CREEK RD",
            "address_2": "SUITE 210",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378625015",
            "telephone_number": "865-446-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "WILLIAM",
        "middle_name": "VINH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-14",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "2978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q021873",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ngo.William@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "744 Middle Creek Rd",
            "address_2": "Suite 210",
            "city": "Sevierville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378625015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sevierville, TN

Sources for this page

Verify at the official NPI Registry.