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DR. JAMES E FOX M.D.
NPI 1952393688
Pain Medicine - Interventional Pain Medicine in Knoxville, TN

Active since August 18, 2005Opted out of Medicare · through Apr 1, 2028
99.59/100
CMS Quality Rating
300 PROSPERITY RD, SUITE 103, KNOXVILLE, TN 37923(865) 246-0143(865) 246-0146 Get Directions Write a Review

NPPES record last updated: July 17, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. James E Fox M.d. NPPES

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

DR. JAMES E FOX M.D. (NPI 1952393688) is an individual interventional pain medicine provider in Knoxville, Tennessee, licensed in Tennessee (MD30702) and active in the NPI registry since August 2005. He has opted out of Medicare through April 1, 2028 and remains eligible to order and refer and is a graduate of University Of Tennessee, Hsc, College Of Medicine (1994).

NPPES Registry Identity

NPI1952393688
Entity TypeIndividualMale
Primary Taxonomy208VP0014X
Provider Legal NameDR. JAMES E FOXCredential: M.D.
Location Address300 PROSPERITY RD, SUITE 103Knoxville, TN 37923-4717
Mailing Address234 Morrell Rd, 304Knoxville, TN 37919-5876 · (865) 246-0143 · Fax (865) 246-0146
Phone(865) 246-0143
Fax(865) 246-0146
Sole ProprietorYes
Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 1994
Enumeration DateAugust 18, 2005
Last NPPES UpdateJuly 17, 2013
✔ NPI 1952393688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0014X
License✔ Licensed in TN · MD30702
Definition
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.
Also ListedRehabilitation PractitionerTaxonomy 225400000X · License MD30702 (TN)
300 PROSPERITY RD, Knoxville, TN 37923
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Other Identifiers 2

Medicare UPING83715
Medicare ID-Type Unspecified3831110TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. James E Fox M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2026 through April 1, 2028.

Opt-Out Effective DateApril 1, 2026
Opt-Out In Effect ThroughApril 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Areas of Expertise CMS Part B claims 10

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.

Testing for presence of drug, by chemistry analyzers 80307
Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.
689 services143 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
651 services142 patients
Evaluation of psychological test, first hour 96130
This procedure involves a professional assessing your mental health using standardized tests. It's the initial hour of a process that helps understand your emotional well-being and cognitive abilities. It's completely non-invasive and confidential.
413 services111 patients
Evaluation of neuropsychological test, first hour 96132
An evaluation of neuropsychological tests is a process to assess your brain's function. It involves tasks designed to measure cognitive abilities such as memory, attention, problem-solving, and language skills. The first hour involves initial testing and observation.
413 services111 patients
Administration of psychological or neuropsychological test by technician, first 30 minutes 96138
This procedure involves a trained technician administering a psychological or neuropsychological test. It's a process that assesses your mental function and behavior. The initial session will last 30 minutes. The aim is to understand your cognitive abilities better.
412 services111 patients
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes G0396
This service involves a structured evaluation of your alcohol or substance use habits. It identifies potential issues and provides brief counseling to help modify harmful behaviors. It's a short, 15-30 minute process, focused on promoting healthier choices.
392 services109 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37923 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.

99.59/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality87.54
Improvement Activities40

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
35%495 patients2/55-star benchmark: 92%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%1,223 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
99%1,099 patients5/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
91%8,867 patients3/55-star benchmark: 100%
Patient-Specific Education
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.
41%1,266 patients2/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
50%391 patients3/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
94%1,225 patients4/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
33%786 patients2/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 93% · 485 patients
Patients tobacco: 97% · 1,072 patients
100%1,072 patients5/55-star benchmark: 98%
Provide Patient Access
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…
63%1,266 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
8%1,266 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
7%1,266 patients
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.

Other Providers at the Same Location NPPES 2

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

ADVANCED PHYSICAL THERAPY OF KNOXVILLE, INC.
Physical Therapist
300 PROSPERITY RD, SUITE #102
KNOXVILLE, TN 37923
Knox County (865) 693-0018
ADEL M HUSSEIN P.T.
Physical Therapist
300 PROSPERITY RD, SUITE # 102
KNOXVILLE, TN 37923
Knox County (865) 693-0018

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 James Fox's NPI number?

The NPI number for James Fox is 1952393688. It was assigned to this individual provider in the NPPES registry on August 18, 2005.

Where is James Fox located?

James Fox practices at 300 Prosperity Rd Suite 103, Knoxville, TN 37923. The listed phone number is (865) 246-0143.

What is James Fox's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Is James Fox enrolled in Medicare?

No. James Fox has opted out of Medicare through April 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does James Fox accept?

Health plans from UnitedHealthcare list James Fox 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.

When was this NPI record last updated?

The NPPES record for James Fox was last updated on July 17, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.