Individual provider Active NPI

Maggie K Johnson, RD

  • Registered Dietitian
  • Knoxville, TN
National Provider Identifier
1104309301
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3487 Issued in TN
Practice address
1450 Dowell Springs Blvd
Suite 300
Knoxville, TN 37909
Phone
(865) 637-8812
Fax
(865) 637-8865
NPI assigned
Sep 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 3487 TN Primary

Addresses

Primary practice location

1450 Dowell Springs Blvd
Suite 300
Knoxville, TN 37909

Mailing address

1450 Dowell Springs Blvd
Suite 300
Knoxville, TN 37909
Phone (865) 637-8812

Other practice location 1

414 Greenbelt Dr
Maryville, TN 37804-5702
Phone (865) 637-8812

Other practice location 2

800 Oak Ridge Tpke Ste A402
Oak Ridge, TN 37830-6951
Phone (865) 637-8812

Other identifiers 1

IdentifierTypeStateIssuer
Q045134MedicaidTN

Other names 1

  • Maggie K Young Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181115000810 TN Practitioner - Registered Dietitian Or Nutrition Professional 2769736420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endocrinology Consultants of East TN 36 clinicians

Practice addresses (Care Compare)

1450 Dowell Springs Blvd
Suite 300
Knoxville, TN 37909-2444
Phone (865) 637-8812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3487TNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endocrinology Consultants of East TN CurrentSince Oct 15, 2018 Accepting new patients

Locations

1450 Dowell Springs Blvd
Ste 300
Knoxville, TN 37909
Phone (865) 470-9820

414 Greenbelt Dr
Maryville, TN 37804
Phone (865) 637-8812

800 Oak Ridge Tpke
Ste A402
Oak Ridge, TN 37830
Phone (865) 637-8812

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.

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1104309301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 DOWELL SPRINGS BLVD",
            "address_2": "SUITE 300",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37909",
            "telephone_number": "865-637-8812",
            "fax_number": "865-637-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 DOWELL SPRINGS BLVD",
            "address_2": "SUITE 300",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37909",
            "telephone_number": "865-637-8812",
            "fax_number": "865-637-8865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "414 Greenbelt Dr",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "TN",
            "postal_code": "378045702",
            "country_code": "US",
            "telephone_number": "865-637-8812",
            "fax_number": "865-342-4678",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Oak Ridge Tpke Ste A402",
            "address_purpose": "LOCATION",
            "city": "Oak Ridge",
            "state": "TN",
            "postal_code": "378306951",
            "country_code": "US",
            "telephone_number": "865-637-8812",
            "fax_number": "865-824-4886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MAGGIE",
        "middle_name": "K",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TN",
            "license": "3487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q045134",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAGGIE",
            "last_name": "YOUNG",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.