Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tennessee Park, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1619504388

Tennessee Park, MD is an Emergency Medicine in Charlottesville, Virginia. Graduated from University of South Florida College of Medicine in 2020, 6 years ago. Practices with Fredericksburg Emergency Medical Alliance, Inc, a 48-clinician group and accepts Medicare assignment.

Years since qualifying
6
Trained at
University of South Florida College of Medicine
In the registry since
2020
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1215 Lee St Mail Stop 800699
Charlottesville, VA 22908-0816
Phone: (434) 924-8485
Fax: (434) 982-4118
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1619504388
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 24, 2020
Last updated in NPPESMarch 24, 2020
Certification dateMarch 24, 2020
Mailing address1215 Lee St, Mail Stop 800699, Charlottesville, VA 22908-0816

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolUNIVERSITY OF SOUTH FLORIDA COLLEGE OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Fredericksburg Emergency Medical Alliance, Inc. — 48 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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