Organization Active NPI

West Knoxville Medical P.L.L.C.

  • General Practice Physician
  • Knoxville, TN
National Provider Identifier
1124689450
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
WEST KNOXVILLE MEDICAL P.L.L.C.
Practice address
6216 Highland Place Way Ste 201
Knoxville, TN 37919-4068
Phone
(896) 287-5904
NPI assigned
Jun 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Authorized official

Name
Nathan LeavittNPI 1699746545
Title
Employee
Phone
(865) 621-6806

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

6216 Highland Place Way Ste 201
Knoxville, TN 37919-4068

Mailing address

6216 Highland Place Way Ste 201
Knoxville, TN 37919-4068
Phone (865) 287-5904

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200205001238 TN Part B Supplier - Clinic/Group Practice 8022444330 Receives reassigned benefits from 7 practitioners
Practice locations: Knoxville, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2319269West Knoxville Medical PLLC6216 Highland Place Way Suite #201, Knoxville, TN 37919Certificate of waiverFeb 25, 2027

National Provider Directory

National Provider Directory

Locations

6311 Kingston Pike
Ste 28W
Knoxville, TN 37919
Phone (865) 287-5904

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1124689450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6216 HIGHLAND PLACE WAY STE 201",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194068",
            "telephone_number": "865-287-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6216 HIGHLAND PLACE WAY STE 201",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194068",
            "telephone_number": "896-287-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST KNOXVILLE MEDICAL P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-26",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "LEAVITT",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "EMPLOYEE",
        "authorized_official_telephone_number": "865-621-6806"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 9, 2024; 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.