MICHAEL LEE GILMORE APRN
NPI 1982942488
Nurse Practitioner - Family in Knoxville, TN
NPI Status: Active since January 18, 2013
Contact Information
1326 PAPERMILL POINTE WAY
KNOXVILLE, TN
ZIP 37909
Phone: (865) 330-6320
- Individual
- Male
- Nurse Practitioner
- Family
- PECOS Enrolled
- Medicare Quality Reporting
About MICHAEL GILMORE
This page provides the complete NPI Profile along with additional information for Michael Gilmore, a provider established in Knoxville, Tennessee with a medical specialization in Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1982942488 assigned on January 2013. The practitioner's primary taxonomy code is 363LF0000X with license number 207QG0300X (TN). The provider is registered as an individual and his NPI record was last updated 10 years ago.
- NPI
- 1982942488
- Provider Name
- MICHAEL LEE GILMORE APRN
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1326 PAPERMILL POINTE WAY KNOXVILLE, TN 37909
- Location Phone
- (865) 330-6320
- Mailing Address
- 1326 PAPERMILL POINTE WAY KNOXVILLE, TN 37909
- Mailing Phone
- (865) 330-6320
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-18-2013
- Last Update Date
- 07-22-2016
- Code Navigator
A nurse practitioner (NP) like Michael Gilmore is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
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
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 207QG0300X
- License State
- TN
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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 |
|---|---|---|---|
| Q020498 | MEDICAID (05) | TN | |
| 103I508549 | MEDICARE PIN (08) | TN |
Medicare Participation & PECOS Enrollment Status
Michael Gilmore 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: Durable Medical Equipment (DME) 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
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Administration of psychological or neuropsychological test by technician, first 30 minutes
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes
Amylase (enzyme) level
Blood test, comprehensive group of blood chemicals
Blood test, thyroid stimulating hormone (tsh)
Cyanocobalamin (vitamin b-12) level
Dehydroepiandrosterone (dhea-s) hormone level
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Evaluation of neuropsychological test, first hour
Evaluation of psychological test, first hour
Folic acid level, serum
Gonadotropin, follicle stimulating (reproductive hormone) level
Gonadotropin, luteinizing (reproductive hormone) level
Hemoglobin a1c level
Lactate dehydrogenase (enzyme) level
Lipase (fat enzyme) level
Magnesium level
Measurement c-reactive protein for detection of infection or inflammation
Measurement of total estradiol (hormone)
Parathormone (parathyroid hormone) level
Phosphate level
Rheumatoid factor level
Sex hormone binding globulin (protein) level
Testing for presence of drug, by chemistry analyzers
Thyroid hormone, t3 measurement, free
Thyroxine (thyroid chemical), free
Urine microalbumin (protein) level
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.
This service was performed 264 times for 130 patientsThis 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.
This service was performed 260 times for 130 patientsAmylase is an enzyme that helps break down starches into sugars during digestion. An amylase level test measures the amount of this enzyme in your blood or urine. This test helps identify conditions like pancreatitis or other digestive issues.
This service was performed 17 times for 17 patientsA comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
This service was performed 20 times for 20 patientsA TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.
This service was performed 17 times for 17 patientsA Cyanocobalamin (Vitamin B-12) level test is a blood test that checks the amount of Vitamin B-12 in your body. This vitamin is vital for nerve function and the creation of red blood cells. Low or high levels could indicate a potential health issue.
This service was performed 16 times for 16 patientsThe Dehydroepiandrosterone (DHEA-S) hormone level test is a blood test that checks the amount of a natural steroid hormone in your body. This hormone helps in managing stress and maintaining overall health. Any imbalance can lead to various health issues.
This service was performed 17 times for 17 patientsA definitive drug test identifies specific drugs in your system. It uses advanced methods like gc/ms and lc/ms, which can distinguish between different types of drugs but not necessarily their 3D forms. This test offers detailed results to support your healthcare decisions.
This service was performed 130 times for 116 patientsThis 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.
This service was performed 17 times for 14 patientsThis 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.
This service was performed 315 times for 155 patientsAn 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.
This service was performed 272 times for 133 patientsThis 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.
This service was performed 271 times for 133 patientsA Folic Acid Level, Serum test measures the amount of folic acid, a type of B vitamin, in your blood. This vitamin is important for cell growth and development. It's crucial for your body to function well. If your levels are low, it may indicate a deficiency, which can lead to health issues.
This service was performed 16 times for 16 patientsThis is a test that measures the level of a hormone in your body known as follicle stimulating hormone (FSH). FSH plays a key role in the body's reproductive processes. It's important for growth and the healthy functioning of the body.
This service was performed 17 times for 17 patientsThis is a blood test that measures the level of luteinizing hormone (LH). LH plays a key role in body growth and development. It's important for the proper functioning of certain glands. Irregular levels can indicate potential health issues.
This service was performed 17 times for 17 patientsHemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
This service was performed 17 times for 17 patientsA Lactate Dehydrogenase level test measures the amount of this enzyme in your body. It's often done when tissue damage is suspected, as high levels can indicate issues like heart disease, lung disease, liver disease, or blood disorders. This test helps in diagnosing and monitoring these conditions.
This service was performed 17 times for 17 patientsA Lipase Level test measures the amount of lipase in your blood. Lipase is an enzyme that helps your body digest fats. High or low levels can indicate problems with your pancreas, such as pancreatitis or other conditions. This test helps your doctor diagnose and monitor these conditions.
This service was performed 17 times for 17 patientsA magnesium level test is a simple blood test that measures the amount of magnesium in your body. Magnesium is a crucial mineral that helps your nerves, muscles, and heart function properly. The test can help detect health conditions like kidney disease or malnutrition.
This service was performed 17 times for 17 patientsC-reactive protein (CRP) test is a blood test that checks for signs of inflammation or infection in the body. High levels of CRP often suggest that there's inflammation or a bacterial infection. This test helps in monitoring and managing conditions like arthritis and heart disease.
This service was performed 18 times for 18 patientsTotal estradiol measurement is a simple blood test that examines the level of a key hormone in your body. This hormone plays a vital role in many body functions. The test helps understand if hormone levels are balanced, which can impact overall health.
This service was performed 18 times for 18 patientsThe Parathormone level test measures the amount of parathyroid hormone in your blood. This hormone controls calcium and phosphorus levels in the body, which are vital for bone health. Abnormal levels may indicate issues like kidney disease or parathyroid gland disorders.
This service was performed 17 times for 17 patientsA phosphate level test measures the amount of phosphate in your blood. Phosphate is a chemical that contains the mineral phosphorus, crucial for energy production, muscle and nerve function, and bone growth. Imbalances may indicate kidney disease or other health issues.
This service was performed 17 times for 17 patientsThe Rheumatoid Factor Level test is a blood test that helps detect the presence of Rheumatoid Factor (RF), a protein produced by your immune system. High RF levels often indicate autoimmune diseases like rheumatoid arthritis. The test involves a simple blood draw and lab analysis.
This service was performed 18 times for 18 patientsSex hormone binding globulin (SHBG) level is a blood test that measures a specific protein in your body. This protein helps regulate certain hormones. If these hormone levels are too high or too low, it may cause health issues. The test helps assess hormone-related conditions.
This service was performed 18 times for 18 patientsChemistry 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.
This service was performed 156 times for 124 patientsThe T3 measurement, free, is a blood test that checks the level of a hormone called triiodothyronine. This hormone is produced by your thyroid, a small gland in your neck. It plays a key role in regulating your body's metabolism and energy use.
This service was performed 17 times for 17 patientsThe Thyroxine (thyroid chemical), free test is a blood test that measures the level of free T4 in your body. T4 is a hormone produced by your thyroid gland and is essential for growth and metabolism. If your T4 levels are too high or too low, it could indicate a thyroid disorder.
This service was performed 17 times for 17 patientsThe urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.
This service was performed 17 times for 17 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 37909 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $81.53
- Minimum New Patient Price $52.64
- Maximum New Patient Price $160.89
- Average New Patient Copayment $20.38
- Minimum New Patient Copayment $13.16
- Maximum New Patient Copayment $40.22
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $93.6
- Minimum Established Patient Price $16.72
- Maximum Established Patient Price $131.41
- Average Established Patient Copayment $23.4
- Minimum Established Patient Copayment $4.18
- Maximum Established Patient Copayment $32.85
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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 |
|---|---|---|
| Annual registration in the Prescription Drug Monitoring Program | Yes | N/A |
| Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months. | ||
| Closing the Referral Loop: Receipt of Specialist Report | 24% | 93 |
| Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred | ||
| Colorectal Cancer Screening | 6% | 671 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Consultation of the Prescription Drug Monitoring Program | Yes | N/A |
| Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance. | ||
| Depression screening | Yes | N/A |
| Depression screening and follow-up plan: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including depression screening and follow-up plan (refer to NQF #0418) for patients with co-occurring conditions of behavioral or mental health conditions. | ||
| Diabetes: Medical Attention for Nephropathy | 56% | 48 |
| The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period | ||
| Documentation of Current Medications in the Medical Record | 99% | 3229 |
| 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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 20% | 1008 |
| 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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 0% | 267 |
| 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 | ||
| Tobacco use | Yes | N/A |
| Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence. | ||
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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 1982942488, 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 1 provider is registered at the same or a nearby location.
KNOXVILLE, TN 37909
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1982942488, enumerated as an "individual" on January 18, 2013.
The provider is located at 1326 PAPERMILL POINTE WAY KNOXVILLE, TN 37909 and the phone number is (865) 330-6320.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
