MR. RODNEY G. CARTER M.D.
NPI 1497862668
General Practice in Pigeon Forge, TN
NPI Status: Active since August 24, 2006
Contact Information
190 COMMUNITY CENTER DR.
SUITE 103
PIGEON FORGE, TN
ZIP 37863
Phone: (865) 446-4032
Fax: (865) 868-4746
- Individual
- Male
- General Practice
- Accepts Insurance
- PECOS Enrolled
- Opted-Out Medicare
- Medicare Quality Reporting
About RODNEY CARTER
This page provides the complete NPI Profile along with additional information for Rodney Carter, a primary care provider established in Pigeon Forge, Tennessee with a medical specialization in General Practice. The healthcare provider is registered in the NPI registry with number 1497862668 assigned on August 2006. The practitioner's primary taxonomy code is 208D00000X with license number 30020 (TN). The provider is registered as an individual and his NPI record was last updated 11 years ago.
- NPI
- 1497862668
- Provider Name
- MR. RODNEY G. CARTER M.D.
- Other Name
- MR. RODNEY G CARTER M.D.
- Other Name Type
- Other Name (5)
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 190 COMMUNITY CENTER DR. SUITE 103 PIGEON FORGE, TN 37863
- Location Phone
- (865) 446-4032
- Location Fax
- (865) 868-4746
- Mailing Address
- 190 COMMUNITY CENTER DR. SUITE 103 PIGEON FORGE, TN 37863
- Mailing Phone
- (865) 446-4032
- Mailing Fax
- (865) 868-4746
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-24-2006
- Last Update Date
- 11-16-2015
- Code Navigator
A primary care provider (PCP) like Rodney Carter sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Rodney Carter opted out of Medicare effective on 10-01-2015 until 10-01-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
General Practice
- Taxonomy Code
- 208D00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 30020
- License State
- TN
- Taxonomy Description
- A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | MD30020 (TN) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � - EPO
- BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health� - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Simple - EPO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - EPO
- Bronze Simple Chronic Care CKM - EPO
- Bronze Simple Diabetes - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Silver Classic - EPO
- Silver Classic Standard - EPO
- UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Essential (No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Gold Advantage (Virtual Urgent Care, No Referrals) - EPO
- UHC Gold Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Gold Copay Focus (Virtual Urgent Care, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Silver Advantage (Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Advantage + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| G66405 | MEDICARE UPIN (02) | TN | |
| 3822589 | MEDICARE ID-TYPE UNSPECIFIED (04) | TN | DR. CARTER AS INDIVIDUAL |
| 3378953 | MEDICARE PIN (08) | TN | |
| 3079526 | OTHER (01) | TN | BLUE CROSS BLUE SHIELD |
| 3378953 | MEDICAID (05) | TN |
Medicare Participation & PECOS Enrollment Status
Rodney Carter is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 10-01-2015
Opt-Out End Date: 10-01-2027
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Patient-Specific Education | 89% | 73 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Provide Patient Access | 64% | 73 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
Reviews for MR. RODNEY G. CARTER M.D.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1497862668, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 72 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
PIGEON FORGE, TN 37863
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1497862668, enumerated as an "individual" on August 24, 2006.
The provider is located at 190 COMMUNITY CENTER DR. SUITE 103 PIGEON FORGE, TN 37863 and the phone number is (865) 446-4032.
General Practice with taxonomy code 208D00000X.
The provider might be accepting Accepts: BlueCross BlueShield of Tennessee, Oscar Insurance. Please consult your insurance carrier or call the provider to verify.
