Kennedy Shull

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

6197 Issued in TN

Practice address

7200 Strawberry Plains Pike
Knoxville, TN 37914-9589

Phone

(865) 240-3038

NPI assigned

Jan 31, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Specialty

Physician Assistant

Education

Medical University of South Carolina College of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Interstate Health Systems IncGroup PAC ID 0749634939, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scotland Memorial Hospital Hospital, Laurinburg, NC, CCN 340008

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Interstate Health Systems, Inc

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1073216990
  Medicare reassignment Care Compare group
• Interstate Health Systems, Inc

  • Rural Health Clinic/Center
  • Knoxville, TN
  • NPI 1437961000
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Scotland Memorial Hospital Inc

  • General Acute Care Hospital
  • Laurinburg, NC
  • NPI 1457345597
  Care Compare affiliation

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

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1154184497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 E OAK HILL AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379175434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 STRAWBERRY PLAINS PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379149589",
            "telephone_number": "865-240-3038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 E Oak Hill Ave",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379175434",
            "country_code": "US",
            "telephone_number": "843-687-9687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHULL",
        "first_name": "KENNEDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6197",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "6197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Hill Shugart, P.T.
• Prem C Shukla, MD
• Robert Keith Shuler Jr., MD
• Ryan W Shuler, COTA/L
• Devin Nathaniel Shull
• Shults Pediatrics, P. C.
• Stephanie Stapleton Shults, M.D.
• Steven Dwight Shults, P.T.A.
• Christopher Shultz
• Edith Hurst Shultz, LCSW

• Medical Physician Assistant in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.