Individual provider Active NPI

Patricia M Huddleston, NP

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1003048810
Registry record updated Oct 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14313 Issued in TN
Practice address
1940 Alcoa Hwy
Ste 180
Knoxville, TN 37920-2244
Phone
(865) 305-6955
Fax
(865) 305-8238
NPI assigned
Aug 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 14313 TN Primary

Addresses

Primary practice location

1940 Alcoa Hwy
Ste 180
Knoxville, TN 37920-2244

Mailing address

1930 Alcoa Hwy
Ste a-235
Knoxville, TN 37920-1500
Phone (865) 305-4670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091020000295 TN Practitioner - Nurse Practitioner 6002953361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

9330 Park W Blvd
Suite 200
Knoxville, TN 37923-4310
Phone (865) 373-5100

Hospital & facility affiliations

  • Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125
  • Leconte Medical Center Hospital, Sevierville, TN, CCN 440081
  • Morristown Hamblen Hospital Association Hospital, Morristown, TN, CCN 440030
  • Fort Loudoun Medical Center Hospital, Lenoir City, TN, CCN 440110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
14313TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. CurrentSince Apr 1, 2014 Accepting new patients
Covenant Medical Group, Inc CurrentSince Apr 1, 2014 Accepting new patients

Locations

9330 Park West Blvd
Ste 200
Knoxville, TN 37923
Phone (865) 373-5100

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1003048810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 ALCOA HWY",
            "address_2": "STE A-235",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201500",
            "telephone_number": "865-305-4670",
            "fax_number": "865-305-4671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 ALCOA HWY",
            "address_2": "STE 180",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379202244",
            "telephone_number": "865-305-6955",
            "fax_number": "865-305-8238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDDLESTON",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-12",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "14313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.