Individual provider Active NPI

Kristin D Evans, NP-C

  • Family Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1104286467
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20981 Issued in TN
Practice address
1651 Gunbarrel Rd Ste 302
Chattanooga, TN 37421
Phone
(423) 899-2904
Fax
(423) 892-5058
NPI assigned
Mar 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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 20981 TN Primary

Addresses

Primary practice location

1651 Gunbarrel Rd Ste 302
Chattanooga, TN 37421

Mailing address

4976 Alpha LN
Hixson, TN 37343-5470
Phone (423) 308-0280

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
I20180620000106 TN Practitioner - Nurse Practitioner 0244585065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Medical Group, PCGroup PAC ID 2668377391, 122 clinicians

Practice addresses (Care Compare)

1651 Gunbarrel Rd
Chattanooga, TN 37421-3291

4976 Alpha LN
Hixson, TN 37343-5470
Phone (423) 308-0280

4980 Alpha LN
Hixson, TN 37343-5470
Phone (423) 870-2450

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Chattanooga, TN, CCN 447495
  • Erlanger Medical Center Hospital, Chattanooga, TN, CCN 440104
  • Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20981TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Medical Group, PC Family CurrentSince May 1, 2018 Accepting new patients

Locations

1651 Gunbarrel Rd
Ste 302
Chattanooga, TN 37421
Phone (423) 899-2904

1651 Gunbarrel Rd
Ste 301
Chattanooga, TN 37421
Phone (423) 899-2580

4976 Alpha Ln
Hixson, TN 37343
Phone (423) 308-0280

Organizations & group practices 1

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": "1456790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1104286467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4976 ALPHA LN",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435470",
            "telephone_number": "423-308-0280",
            "fax_number": "423-308-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 GUNBARREL RD STE 302",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37421",
            "telephone_number": "423-899-2904",
            "fax_number": "423-892-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KRISTIN",
        "middle_name": "D",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-01",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "20981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.