KNOXVILLE DERMATOLOGY GROUP PC (NPI# 1063736122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063736122 |
| Entity Type | Organization |
| Organization Name | KNOXVILLE DERMATOLOGY GROUP PC |
| Practice Address |
1928 Alcoa Hwy Suite 209 Knoxville TN 37920-1502 |
| Practice Telephone | 8656909467 |
| Practice Fax Number | 8653425857 |
| Mailing Telephone | 8656909467 |
| Mailing Fax Number | 8653425857 |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2010-03-18 |
| Authorized Official Name | DR. ANTHONY L MEYERS (TRES) |
| Authorized Official Telephone | 8656909467 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689853806 | Knoxville Dermatology Group PC | Non-Pharmacy Dispensing Site | 200 Fort Sanders West Blvd, Suite 102, Knoxville, TN 37922-3357 | 2007-10-25 |
| 1679761274 | Knoxville Dermatology Group PC | Non-Pharmacy Dispensing Site | 1928 Alcoa Hwy, Suite 209, Knoxville, TN 37920-1502 | 2007-10-09 |
| 1760419014 | Knoxville Dermatology Group PC | Dermatology | 200 Fort Sanders West Blvd, Suite 102, Knoxville, TN 37922-3357 | 2006-06-26 |
| Street Address |
1928 ALCOA HWY SUITE 209 |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37920-1502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316948029 | Edward D Kim | Urology | 1928 Alcoa Hwy, Bldg B Suite 222, Knoxville, TN 37920-1502 | 2005-08-03 |
| 1821625849 | Mary Elizabeth Booker | Student in an Organized Health Care Education/Training Program | 1928 Alcoa Hwy, Knoxville, TN 37920-1502 | 2020-03-27 |
| 1225665508 | Leanne Elizabeth Brechtel | Student in an Organized Health Care Education/Training Program | 1928 Alcoa Hwy, Knoxville, TN 37920-1502 | 2020-03-25 |
| 1780231654 | Kelly Jane Tipton | Student in an Organized Health Care Education/Training Program | 1928 Alcoa Hwy, Knoxville, TN 37920-1502 | 2019-08-24 |
| 1578024873 | Kristen Michelle Lilly | Student in an Organized Health Care Education/Training Program | 1928 Alcoa Hwy, Knoxville, TN 37920-1502 | 2019-03-28 |
| 1720548662 | Sandberg Foot Health Center PC | Podiatrist | 1928 Alcoa Hwy, Building B., Suite 200, Knoxville, TN 37920-1502 | 2019-03-25 |
| 1811457872 | Laurel Pace Carbone | Student in an Organized Health Care Education/Training Program | 1928 Alcoa Hwy, Knoxville, TN 37920-1502 | 2019-03-24 |
| 1598225617 | Elizabeth Ljuba Mirsky | Student in an Organized Health Care Education/Training Program | 1928 Alcoa Hwy, Knoxville, TN 37920-1502 | 2019-03-24 |
| 1629565239 | Elizabeth Altizer | Student in an Organized Health Care Education/Training Program | 1928 Alcoa Hwy, Knoxville, TN 37920-1502 | 2018-04-18 |
| 1093211849 | Charlotte B Mccarley | Student in an Organized Health Care Education/Training Program | 1928 Alcoa Hwy, Knoxville, TN 37920-1502 | 2018-04-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033747639 | Paul Connor Shanahan | Student in an Organized Health Care Education/Training Program | 1924 Alcoa Highway, U-109, Knoxville, TN 37920 | 2020-03-30 |
| 1952938904 | Eric Becker | Student in an Organized Health Care Education/Training Program | 1924 Alcoa Highway, U-60, Knoxville, TN 37920 | 2020-03-26 |
| 1174028336 | Taylor Boulware Tapscott | Nurse Practitioner | 3118 Alcoa Highway, Knoxville, TN 37920 | 2018-03-28 |
| 1255860672 | Eric Christopher Riedinger | Student in an Organized Health Care Education/Training Program | 1924 Alcoa Hwy., Box U-11, Knoxville, TN 37920 | 2017-06-08 |
| 1740639277 | Claudia Nieuwoudt | Student in an Organized Health Care Education/Training Program | 1924 Alcoa Highway, Box U-27, Knoxville, Tn 37920, Knoxville, TN 37920 | 2016-06-06 |
| 1841657699 | Frances D Thompson | Physical Therapy Assistant | 717 Lower Pond Way, Knoxville, TN 37920 | 2016-01-25 |
| 1720457989 | Independent Physical Therapy, LLC | Occupational Therapist | 7558 Mountain Grove Dr, Knoxville, TN 37920 | 2015-09-17 |
| 1982071189 | Ryan Dulling | Physical Therapist | 4011 Chapman Hwy Ste J, Knoxville, TN 37920 | 2015-08-24 |
| 1154705614 | Kailyn Sorensen | Physical Therapist | 1926 Alcoa Hwy Ste 200, Knoxville, TN 37920 | 2015-07-15 |
| 1093196420 | James Michael Hart II | Family Medicine | 1925 Alcoa Hwy # 56, Knoxville, TN 37920 | 2015-06-11 |
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| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245679661 | Maya Aravind Raiman | Dermatology | 939 E Emerald Ave Ste 705, Knoxville, TN 37917-4573 | 2013-06-19 |
| 1619235355 | Robert Denison Griffith | Dermatology | 6311 Kingston Pike Ste 22e, Knoxville, TN 37919 | 2012-05-01 |
| 1619204476 | Carley O'shea Fowler | Dermatology | 220 Fort Sanders West Blvd Ste 100, Knoxville, TN 37922-3373 | 2009-11-14 |
| 1861439648 | Kevin Blazer | Dermatology | 1928 Alcoa Hwy Ste 209, Knoxville, TN 37920-1504 | 2006-06-01 |
| 1306891494 | Matthew Brent Doppelt | Dermatology | 1924 Pinnacle Pt, 300, Knoxville, TN 37922-6648 | 2006-05-24 |
| 1073589925 | Elizabeth Brittian Anderson | Dermatology | 6516 Kingston Pike, Knoxville, TN 37919-4825 | 2006-02-28 |
| 1942286729 | George C Keough | Dermatology | 123 Fox Rd, Knoxville, TN 37922-3369 | 2005-12-22 |
| 1134105919 | Edward John Primka IIi | Dermatology | 1450 Dowell Springs Blvd Ste 210, Knoxville, TN 37909-2448 | 2005-12-22 |
| 1023534732 | Brittany Noel Ware | Dermatology | 10215 Kingston Pike Ste 200, Knoxville, TN 37922-3492 | 2017-08-15 |
| 1851747695 | Joshua Randall Bakke | Dermatology | 6516 Kingston Pike, Knoxville, TN 37919-4825 | 2016-05-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.