Individual provider Active NPI

Beth Anne Wiles, APN, FNP-C

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1003462698
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
25912 Issued in TN
Practice address
9320 Park West Blvd
Knoxville, TN 37923-4301
Phone
(865) 373-7100
NPI assigned
Aug 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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 25912 TN Primary

Addresses

Primary practice location

9320 Park West Blvd
Knoxville, TN 37923-4301

Mailing address

9320 Park West Blvd
Knoxville, TN 37923-4301
Phone (865) 373-7100

Other identifiers 1

IdentifierTypeStateIssuer
Q053034MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wiles.beth.anne@covenanthealth.cernerdirect.com

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
I20241213002620 TN Practitioner - Nurse Practitioner 7517493505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Lincoln Memorial University Medical Department, 2019
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)

9320 Parkwest Blvd
Knoxville, TN 37923-4301
Phone (865) 373-7100

Hospital & facility affiliations

  • Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173
  • Fort Loudoun Medical Center Hospital, Lenoir City, TN, CCN 440110
  • Roane Medical Center Hospital, Harriman, TN, CCN 440031

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. CurrentSince Oct 7, 2024 Accepting new patients
Covenant Medical Group, Inc CurrentSince Oct 7, 2024 Accepting new patients

Locations

9320 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-7100

Dept 888179
Knoxville, TN 37995

689 Medical Park Dr
Ste 301
Lenoir City, TN 37772
Phone (865) 988-6330

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

Interoperability endpoints

  • Direct secure messaging: wiles.beth.anne@covenanthealth.cernerdirect.com

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 3

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": "1565395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1003462698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9320 PARK WEST BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234301",
            "telephone_number": "865-373-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 PARK WEST BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234301",
            "telephone_number": "865-373-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILES",
        "first_name": "BETH",
        "middle_name": "ANNE",
        "credential": "APN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-10",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "25912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q053034",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wiles.beth.anne@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "9320 Park West Blvd",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379234301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.