DR. TIDENCE LANE PRINCE (MD) – Allergy & Immunology Physician, NPI 1215922356

DR. TIDENCE LANE PRINCE (MD) is a healthcare provider. based in Knoxville, Tennessee. specializing in ALLERGY/IMMUNOLOGY. They hold the professional credentials MD. They hold a License No. 21247 (TN). The NPI Number for DR. TIDENCE LANE PRINCE (MD) is 1215922356

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
DR. TIDENCE LANE PRINCE (MD)
NPI
1215922356
Phone
(865) 584-5727
Address
6701 BAUM DR
Enumeration Date
14 September 2005
Last Update Date
2 January 2026

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
1989 (37 years ago)
PAC ID
3375585276
Group Practice PAC ID
3274068234
Professional Enrollment ID
I20050601000274
Address ID
TN378013904Ma616XXPKWY500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Digital endpointsOther names

120 ALLERGY/IMMUNOLOGY in TN

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Provider Addresses for DR. TIDENCE LANE PRINCE (MD)

  • 6701, Baum Drive, Bearden Commercial Park, Bearden, Knoxville, Knox County, East Tennessee, Tennessee, 37919, United States

    SUITE 140

    KNOXVILLE, TN 379197360

    Phone: (865) 584-5727

    Fax: (865) 450-9904

    Type: Mailing

  • 611, Morganton Square Drive, Cherokee Park, Maryville, Blount County, East Tennessee, Tennessee, 37801, United States

    MARYVILLE, TN 378014763

    Phone: (865) 584-8588

    Fax: (865) 584-3364

    Type: Location

  • 616 W. LAMAR ALEXANDER PARKWAY

    MARYVILLE, TN 378014763

    Phone: (865) 273-0008

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 220 Open Payments records for all available years, with a total value of $52,429.

Total Amount is formed as General ($52,429) + Research ($0) + Ownership ($0) = $52,429.

Last reported payment date: 2024-12-23 • Largest payer in this snapshot: CSL Behring ($14,117).

Total Amount

$52,429

General + Research + Ownership

Payments

220

Total payment records

General Amount

$52,429

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

1

Ownership records

Last Payment Date

2024-12-23

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-11-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050601000274IAllergy/ImmunologyTNTBD
I20121115000440IAllergy/ImmunologyGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J1575Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin89,87522$0
95165Professional service for preparation and provision of 1 or more antigens15,705421$0
95004Test for allergy using allergenic extract6,50394$0
95117Professional service for multiple injections of allergen3,211578$0
95024Test for allergy using allergenic extract injected into skin1,42786$0
View full utilization report →

Insurance plans in this area (ZIP 37919)

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Provider's Procedures

DR. TIDENCE LANE PRINCE (MD) performs procedures in ALLERGY/IMMUNOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ALLERGY/IMMUNOLOGYTN94060Measurement and graphic recording of the amount and speed of breathed air, before and following medication administration4847
ALLERGY/IMMUNOLOGYTN95004Injection of allergenic extracts into skin, accessed through the skin10099131

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3274068234View full group profile
NameSpecialtyState
Pediatric Medicine, Emergency MedicineTN
A L L E R G Y/ I M M U N O L O G YTN
Pediatric Medicine, Allergy/ImmunologyTN
A L L E R G Y/ I M M U N O L O G YTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
A L L E R G Y/ I M M U N O L O G YTN
Allergy/Immunology, Internal MedicineTN
Nurse PractitionerTN

Reviews

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Frequently asked questions

What is the registry number for DR. TIDENCE LANE PRINCE (MD)?
The registry entry for DR. TIDENCE LANE PRINCE (MD) shows NPI 1215922356.
Should I treat DR. TIDENCE LANE PRINCE (MD) as an active provider?
Patients and plans typically see DR. TIDENCE LANE PRINCE (MD) as active in the national extract.
What does the directory say DR. TIDENCE LANE PRINCE (MD) does?
Insurance directories may phrase it differently, but here DR. TIDENCE LANE PRINCE (MD) maps to Allergy & Immunology Physician. Clinical services aligned with this taxonomy classification.
Is DR. TIDENCE LANE PRINCE (MD) tied to Knoxville, Tennessee?
If you are local to Knoxville, Tennessee, DR. TIDENCE LANE PRINCE (MD) may be relevant to your search.
Can I export DR. TIDENCE LANE PRINCE (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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