DR. CHARLES JOSEPH ALLDERDICE (NPI# 1104262096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104262096 |
| Entity Type | Individual |
| Full Name | DR. CHARLES JOSEPH ALLDERDICE |
| Credential | M.D. |
| Practice Address |
9320 Park West Blvd Knoxville TN 37923-4301 |
| Mailing Address |
1924 Alcoa Highway Department of Medicine U-114 Gsm, Utmck Knoxville TN 37920 |
| Practice Telephone | 8653737100 |
| Practice Fax Number | 8653742029 |
| Mailing Telephone | 8653059340 |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2020-08-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
61180 | TN | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
61180 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q058411 | 05 |
| Street Address |
9320 PARK WEST BLVD |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37923-4301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609866037 | Michael Fuerst | Nurse Practitioner | 9320 Park West Blvd, Knoxville, TN 37923-4301 | 2005-10-26 |
| 1295385300 | Kristina L Needham | Nurse Practitioner | 9320 Park West Blvd, Knoxville, TN 37923-4301 | 2019-09-19 |
| 1871053736 | Rebecca Goldston Nicholson | Registered Nurse | 9320 Park West Blvd, Knoxville, TN 37923-4301 | 2019-03-25 |
| 1942724414 | Amanda D Underwood | Nurse Practitioner | 9320 Park West Blvd, Knoxville, TN 37923-4301 | 2017-07-27 |
| 1134591894 | Jadeleize Gormley | Nurse Practitioner | 9320 Park West Blvd, Knoxville, TN 37923 | 2015-10-21 |
| 1720477961 | Aimee Todd | Physician Assistant | 9320 Park West Blvd, Knoxville, TN 37923-4301 | 2015-01-12 |
| 1487064283 | Jaime C Holbert | Internal Medicine | 9320 Park West Blvd, Knoxville, TN 37923-4301 | 2014-05-01 |
| 1932456621 | Sara Negrotto | Internal Medicine | 9320 Park West Blvd, Knoxville, TN 37923-4301 | 2012-08-13 |
| 1881871374 | Ayaz Rahman | Internal Medicine | 9320 Park West Blvd, Knoxville, TN 37923-4301 | 2008-01-28 |
| 1528198272 | Ogei Yar | Internal Medicine | 9320 Park West Blvd, Knoxville, TN 37923-4301 | 2007-03-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114541240 | Chloe Morgan | Registered Nurse | Parkwest Blvd, Knoxville, TN 37923 | 2020-06-04 |
| 1215551346 | Kaylee Huskey | Registered Nurse | Park West Blvd, Knoxville, TN 37923 | 2020-06-04 |
| 1942849914 | American Brace & Limb Enterprise, LLC | Prosthetic/Orthotic Supplier | 9333 Parkwest Blvd., 103, Knoxville, TN 37923 | 2019-12-23 |
| 1619510690 | Stacia Working | Speech-Language Pathologist | 310 Corporate Dr, Ste 101, Knoxville, TN 37923 | 2019-10-23 |
| 1497242903 | Mary Ensminger Loomis | Speech-Language Pathologist | 118 N Peters Rd Ste 174, Knoxville, TN 37923 | 2018-04-19 |
| 1831699602 | Shaun Elizabeth Hoffman | Counselor | 311 Directors Dr, Knoxville, TN 37923 | 2018-02-17 |
| 1962948737 | East Tennessee Binocular Vision Center Pllc | Optometrist | 9051 Executive Park Dr., Ste. 400, Knoxvville, TN 37923 | 2017-01-17 |
| 1467815761 | Hearing Conservation Associates Inc | Audiologist | 9301 Parkwest Blvd B-3, Knoxville, TN 37923 | 2016-04-04 |
| 1710354725 | Independent Physical Therapy, LLC | Occupational Therapist | 8905 Town and Country Cir Ste 9, Knoxville, TN 37923 | 2015-08-25 |
| 1568863553 | Kathryn Faye Ledbetter | Registered Nurse | 9352 Park W Blvd, Knoxville, TN 37923 | 2014-09-09 |
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| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730460718 | Ronald Craig Sebold | Internal Medicine | 7450 Chapman Hwy, #309, Knoxville, TN 37920-6614 | 2011-09-02 |
| 1689017535 | Christopher David Capps | Internal Medicine | 1819 Clinch Ave Ste 108, Knoxville, TN 37916-2435 | 2013-04-10 |
| 1689829590 | Janet Lillian Eichholz | Internal Medicine | 10800 Parkside Dr Ste 331, Knoxville, TN 37934-1922 | 2008-11-19 |
| 1003017963 | Joshua Weber Todd | Internal Medicine | 1819 W Clinch Ave, Suite 108, Knoxville, TN 37916-2435 | 2007-05-29 |
| 1811954860 | Brian James Adams | Internal Medicine | 1819 Clinch Avenue, Suite 108, Knoxville, TN 37916-2435 | 2006-04-26 |
| 1669462230 | Ravi Mehta | Internal Medicine | 10800 Parkside Dr, Suite 331, Knoxville, TN 37934-1922 | 2005-10-25 |
| 1588653141 | Thomas Miller Ayres | Internal Medicine | 1819 W Clinch Ave, Suite 108, Knoxville, TN 37916-2435 | 2005-10-17 |
| 1821087479 | David Emerson Wood | Internal Medicine | 1819 Clinch Avenue, Suite 108, Knoxville, TN 37916-2435 | 2005-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972145456 | Cardiovascular & Vein Associates Pllc | Internal Medicine | 2785 Summer Oaks Dr, Bartlett, TN 38134-2883 | 2019-10-16 |
| 1063910529 | James Joseph Acker I | Internal Medicine | 205 Todaly Cir, Loudon, TN 37774-2990 | 2018-01-30 |
| 1215445192 | Cardiac Cin of Middle Tennessee LLC | Internal Medicine | 315 Deaderick St Ste 1550c, Nashville, TN 37238-3000 | 2018-01-13 |
| 1588172464 | Cardiac Cin of West Tennessee LLC | Internal Medicine | 5865 Ridgeway Center Pkwy Ste 300c, Memphis, TN 38120-4032 | 2018-01-13 |
| 1922520873 | Telemedico Physicians Professional Corporation | Internal Medicine | 5490 Shady Grove Ter, Memphis, TN 38120-2414 | 2017-07-12 |
| 1114455326 | Nashville Heart and Vascular | Internal Medicine | 397 Wallace Rd Ste C216, Nashville, TN 37211-8019 | 2017-06-01 |
| 1942631387 | Cvc Imaging LLC | Internal Medicine | 9203 Sheridan Park Ct, Brentwood, TN 37027-1748 | 2013-12-11 |
| 1467494070 | Apex Cardiology PC | Internal Medicine | 327 Summar Dr, Jackson, TN 38301-3930 | 2006-06-11 |
| 1700823960 | Thomas Little | Internal Medicine | 228 W. 4th Street, Suite 200, Cookeville, TN 38501 | 2006-05-31 |
| 1801863105 | Eric Raul Guerra | Internal Medicine | 2253 Chambliss Ave Nw Ste 301, Cleveland, TN 37311-3961 | 2006-03-06 |
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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.