Individual provider Active NPI

Venkata C Gourineni, MD

  • Gastroenterology Physician
  • Oak Ridge, TN
National Provider Identifier
1972733616
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
45468 Issued in TN
Practice address
988 Oak Ridge Tpke
Suite 200
Oak Ridge, TN 37830-6930
Phone
(865) 483-4366
NPI assigned
Jul 15, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 51178 CT
Gastroenterology Physician 207RG0100X 45468 TN Primary

Addresses

Primary practice location

988 Oak Ridge Tpke
Suite 200
Oak Ridge, TN 37830-6930

Mailing address

988 Oak Ridge Tpke
Suite 200
Oak Ridge, TN 37830-6930
Phone (865) 483-4366

Other identifiers 1

IdentifierTypeStateIssuer
Q022553MedicaidTN

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
I20160822002910 TN Practitioner - Gastroenterology 2264680149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
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

988 Oak Ridge Tpke
Suite 200
Oak Ridge, TN 37830-6919
Phone (865) 483-4366

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
  • Cumberland Medical Center Hospital, Crossville, TN, CCN 440009

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy78
Upper gastrointestinal (GI) endoscopy for acid reflux114

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc CurrentSince Sep 1, 2016 Accepting new patients
Covenant Medical Group, Inc. Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients

Locations

Dept 888179
Knoxville, TN 37995

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

988 Oak Ridge Tpke
Ste 200
Oak Ridge, TN 37830
Phone (865) 483-4366

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1972733616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 OAK RIDGE TPKE",
            "address_2": "SUITE 200",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306930",
            "telephone_number": "865-483-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 OAK RIDGE TPKE",
            "address_2": "SUITE 200",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306930",
            "telephone_number": "865-483-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOURINENI",
        "first_name": "VENKATA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-15",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "51178",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "45468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q022553",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.