CHARLES B ORTON MD
NPI 1316262777
Internal Medicine - Gastroenterology in Oak Ridge, TN

Q: What is Charles Orton's NPI number?

The NPI number for Charles Orton is 1316262777. It was assigned to this individual provider in the NPPES registry on March 29, 2010.

Q: What is Charles Orton's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Charles Orton was last updated on June 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 29, 2010PECOS EnrolledAccepts Medicare Assignment

81.99/100

CMS Quality Rating

988 OAK RIDGE TPKE, STE 200, OAK RIDGE, TN 37830(865) 483-4366(865) 483-5957 Get Directions Write a Review

NPPES record last updated: June 24, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Charles B Orton Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES B ORTON MD (NPI 1316262777) is an individual gastroenterology provider in Oak Ridge, Tennessee, licensed in Tennessee (54077) and active in the NPI registry since March 2010. He is enrolled in Medicare PECOS, is affiliated with Cumberland Medical Center, and is a graduate of East Tennessee State University Quillen College Of Medicine (2010).

NPPES Registry Identity

NPI1316262777

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameCHARLES B ORTONCredential: MD

Location Address988 OAK RIDGE TPKE, STE 200Oak Ridge, TN 37830-6930

Mailing Address988 Oak Ridge Tpke, Ste 200Oak Ridge, TN 37830-6930 · (865) 483-4366 · Fax (865) 483-5957

Phone(865) 483-4366

Fax(865) 483-5957

Sole ProprietorNo

Medical School CMSEast Tennessee State University Quillen College Of MedicineGraduated 2010

Enumeration DateMarch 29, 2010

Last NPPES UpdateJune 24, 2020

NPPES CertifiedJune 24, 2020

✔ NPI 1316262777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in TN · 54077

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

988 OAK RIDGE TPKE, Oak Ridge, TN 37830

Open in Google Maps ↗

Other Identifiers 1

MedicaidQ021336TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Charles B Orton Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9436386307

PECOS Enrollment IDI20160719001436

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Charles Orton reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Covenant Medical Group, Inc.

8.1 mi

Family Medicine

1420 CENTERPOINT BLVD
Knoxville, TN 37932

Reassigned Medicare billing, Tennessee enrollment
504 clinicians in this Medicare group

NPI 1457302010 (865) 374-5200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 16

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

232 services231 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

141 services138 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

141 services117 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

68 services63 patients

Insertion of guide wire with dilation of esophagus using a flexible endoscope 43248

This is a procedure where a thin tube, called an endoscope, is gently passed through your mouth into your esophagus. A guide wire is then inserted to help widen any narrow areas. This helps improve swallowing and reduce discomfort.

63 services59 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

49 services49 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

46 services40 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

40 services32 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

29 services29 patients

Removal of stone or debris from bile or pancreatic duct using a flexible endoscope 43264

This procedure, called an endoscopic retrograde cholangiopancreatography (ERCP), involves using a flexible tube with a camera (endoscope) to locate and remove stones or debris from your bile or pancreatic duct. It's a non-surgical method to clear the ducts, enhancing your digestive health.

24 services22 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

23 services19 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

17 services17 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

16 services16 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

14 services13 patients

Destruction of polyp or growth of large bowel using a flexible endoscope 45388

This procedure involves the removal of a polyp or growth in the large bowel. A flexible endoscope, a thin tube with a camera, is inserted through the rectum to visualize and remove the growth. This helps maintain bowel health and prevent complications.

12 services12 patients

Incision of pancreatic outlet using a flexible endoscope 43262

This procedure involves a small cut in the outlet of the pancreas using a flexible tube with a camera, called an endoscope. It helps doctors diagnose and treat conditions affecting the pancreas, enhancing patient comfort and recovery.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Cumberland Medical Center

Acute Care Hospitals · Crossville, TN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440009

Location421 S Main StCrossville, TN 38555 · Cumberland County

Emergency services Birthing friendly

Roane Medical Center

Acute Care Hospitals · Harriman, TN

5/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number440031

Location8045 Roane Medical Center DriveHarriman, TN 37748 · Roane County

Emergency services

Methodist Medical Center Of Oak Ridge

Acute Care Hospitals · Oak Ridge, TN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440034

Location990 Oak Ridge Turnpike Box 529Oak Ridge, TN 37830 · Anderson County

Emergency services Birthing friendly

Fort Sanders Regional Medical Center

Acute Care Hospitals · Knoxville, TN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440125

Location1901 W Clinch AveKnoxville, TN 37916 · Knox County

Emergency services Birthing friendly

Parkwest Medical Center

Acute Care Hospitals · Knoxville, TN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440173

Location9352 Park West BlvdKnoxville, TN 37923 · Knox County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37830 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$121.80 typical visit price

range $52.64 – $160.89

Typical copayment $30.45 (range $13.16 – $40.22)

Most-billed visit code 99204

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.99/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

88.93

Promoting Interoperability

100

Improvement Activities

Cost

51.05

Reported Quality Measures

Breast Cancer Screening

71%161 patients4/55-star benchmark: 93%

Colorectal Cancer Screening

79%371 patients4/55-star benchmark: 88%

Documentation of Current Medications in the Medical Record

99%850 patients4/55-star benchmark: 100%

e-Prescribing

99%488 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

99%335 patients4/55-star benchmark: 100%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

92%511 patients4/55-star benchmark: 97%

Provide Patients Electronic Access to Their Health Information

99%469 patients4/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

78%298 patients4/55-star benchmark: 91%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150

Other-Enteral and Parenteral · category OB006N

2 suppliers12 claims6,748 services$0.31 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MARY S CLEMENS FNP

Nurse Practitioner (Family)

988 OAK RIDGE TPKE, SUITE L-50, PHYSICIANS PLAZA
OAK RIDGE, TN 37830

Anderson County (865) 835-4320

MRS. MARY CHRISTINA STAUBER P.A.-C.

Physician Assistant (Surgical)

988 OAK RIDGE TPKE, PHYSICIANS PLAZA, STE 350
OAK RIDGE, TN 37830

Anderson County (865) 483-7030

DR. SCOTT W PETERS MD

Obstetrics & Gynecology

988 OAK RIDGE TPKE, SUITE 140
OAK RIDGE, TN 37830

Anderson County (865) 483-7415

OAK RIDGE GASTROENTEROLOGY ASSOCIATES, PC

Internal Medicine (Gastroenterology)

988 OAK RIDGE TPKE, SUITE 200, PHYSICIANS PLAZA
OAK RIDGE, TN 37830

Anderson County (865) 483-4366

DR. KATHRYN J HAYES MD

Obstetrics & Gynecology

988 OAK RIDGE TPKE, SUITE 140
OAK RIDGE, TN 37830

Anderson County (865) 483-7415

RONALD KEITH WRAY MD

Internal Medicine (Gastroenterology)

988 OAK RIDGE TPKE, SUITE 200, PHYSICIANS PLAZA
OAK RIDGE, TN 37830

Anderson County (865) 483-4366

DR. DAVID GRANVILLE STANLEY M.D.

Surgery (Vascular Surgery)

988 OAK RIDGE TPKE, PHYSICIANS PLAZA, STE 350
OAK RIDGE, TN 37830

Anderson County (865) 483-7030

DR. JOSEPH METCALF IV MD

Surgery

988 OAK RIDGE TPKE, SUITE 350
OAK RIDGE, TN 37830

Anderson County (865) 483-7030

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Orton's NPI number?

The NPI number for Charles Orton is 1316262777. It was assigned to this individual provider in the NPPES registry on March 29, 2010.

Where is Charles Orton located?

Charles Orton practices at 988 Oak Ridge Tpke Ste 200, Oak Ridge, TN 37830. The listed phone number is (865) 483-4366.

What is Charles Orton's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Charles Orton enrolled in Medicare?

Yes. Charles Orton is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Charles Orton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Charles Orton reassigns Medicare benefits to Covenant Medical Group, Inc. (Knoxville, TN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Charles Orton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Charles Orton accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 2 other insurers list Charles Orton as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Charles Orton affiliated with any hospitals?

According to CMS data, Charles Orton is affiliated with Cumberland Medical Center, Roane Medical Center, Methodist Medical Center Of Oak Ridge, Fort Sanders Regional Medical Center and Parkwest Medical Center.

When was this NPI record last updated?

The NPPES record for Charles Orton was last updated on June 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.