Individual provider Active NPI

Mary Kochman, DO

  • Family Medicine Physician
  • Clinton, TN
National Provider Identifier
1104484823
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4975 Issued in TN
Practice address
110 Executive Park Dr
Clinton, TN 37716-6876
Phone
(865) 494-9241
NPI assigned
May 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4975 TN Primary

Addresses

Primary practice location

110 Executive Park Dr
Clinton, TN 37716-6876

Mailing address

110 Executive Park Dr
Clinton, TN 37716-6876
Phone (865) 494-9241

Other identifiers 1

IdentifierTypeStateIssuer
Q078457MedicaidTN

Other names 1

  • Mary Hoehl Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hoehl.mary@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230126001410 TN Practitioner - Family Practice 4789055971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rowan University School of Osteopathic Medicine, 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)

111 Clyde St
Loudon, TN 37774-1600
Phone (865) 458-1554

6600 Nightingale LN
Knoxville, TN 37909-2754
Phone (865) 632-5885

Hospital & facility affiliations

  • Amedisys Home Health of Tennessee Home health agency, Tazewell, TN, CCN 447188
  • Methodist Medical Center of Oak Ridge Hospital, Oak Ridge, TN, CCN 440034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. Family Medicine CurrentSince Oct 20, 2022 Accepting new patients
Covenant Medical Group, Inc CurrentSince Oct 20, 2022 Accepting new patients
Crossville Medical Group PA PastSince Oct 23, 2022 Accepting new patients

Locations

110 Executive Park Dr
Clinton, TN 37716
Phone (865) 494-9241

Dept 888179
Knoxville, TN 37995

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

Interoperability endpoints

  • Direct secure messaging: hoehl.mary@covenanthealth.cernerdirect.com

Organizations & group practices 3

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 2

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": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1104484823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 EXECUTIVE PARK DR",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377166876",
            "telephone_number": "865-494-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 EXECUTIVE PARK DR",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377166876",
            "telephone_number": "865-494-9241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHMAN",
        "first_name": "MARY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "4975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q078457",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hoehl.mary@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "110 Executive Park Dr",
            "city": "Clinton",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377166876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "HOEHL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clinton, TN

Sources for this page

Verify at the official NPI Registry.