Individual provider Active NPI

Kaitlyn Dorthea Harrill, APRN

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1134834377
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
33123 Issued in TN
Practice address
501 19TH St Ste 401
Knoxville, TN 37916-1831
Phone
(865) 331-2020
NPI assigned
Jan 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 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 33123 TN Primary

Addresses

Primary practice location

501 19TH St Ste 401
Knoxville, TN 37916-1831

Mailing address

501 19TH St Ste 401
Knoxville, TN 37916-1831
Phone (865) 331-2020

Other identifiers 1

IdentifierTypeStateIssuer
Q080515MedicaidTN

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
I20230406002130 TN Practitioner - Nurse Practitioner 4587039409 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33123TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Sanders Perinatal Center CurrentSince Feb 13, 2023 Accepting new patients

Locations

501 19th St
Ste 401
Knoxville, TN 37916
Phone (865) 331-2020

Dept 888247
Knoxville, TN 37995

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": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1134834377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 19TH ST STE 401",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161831",
            "telephone_number": "865-331-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 19TH ST STE 401",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161831",
            "telephone_number": "865-331-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRILL",
        "first_name": "KAITLYN",
        "middle_name": "DORTHEA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "33123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q080515",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.