Individual provider Active NPI

Kristen Beth Dettorre, MD

  • Emergency Medicine Physician
  • Nashville, TN
National Provider Identifier
1154478964
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
44731 Issued in TN
Practice address
3601 TVC
Nashville, TN 37232-0001
Phone
(615) 322-3000
NPI assigned
Jan 4, 2007
Last updated
Apr 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 44731 TN Primary

Addresses

Primary practice location

3601 TVC
Nashville, TN 37232-0001

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691
Phone (615) 322-3000

Other practice location 1

1801 N Jackson St
Tullahoma, TN 37388-2201
Phone (615) 875-6415

Other practice location 2

2835 Highway 231 N
Shelbyville, TN 37160-7327
Phone (615) 875-6415

Other practice location 3

1411 W Baddour Pkwy
Lebanon, TN 37087-2513
Phone (615) 875-6415

Other identifiers 1

IdentifierTypeStateIssuer
1513724MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kdettorre21598@direct.vumc.org Direct

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
I20090615000710 TN Practitioner - Emergency MedicinePractitioner - Anesthesiology 8426108390 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Anesthesiology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vanderbilt University Medical CenterGroup PAC ID 5092023416, 3,510 clinicians

Practice addresses (Care Compare)

1301 Medical Ctr Dr
Nashville, TN 37232-0028
Phone (615) 322-5000

1401 W Baddour Pkwy
Lebanon, TN 37087-2513
Phone (615) 443-2550

1411 W Baddour Pkwy
Lebanon, TN 37087-2513
Phone (615) 444-8262

2835 Hwy 231 N
Shelbyville, TN 37160-7327
Phone (931) 685-5433

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vanderbilt University Medical Center Emergency Medicine CurrentSince Apr 30, 2016 Accepting new patients
Middle Tennessee Emergency Physicians PC Emergency Medicine CurrentSince Aug 1, 2010 Accepting new patients
Vanderbilt Integrated Providers, LLC CurrentSince May 1, 2025 Accepting new patients
Vanderbilt Integrated Providers, LLC Emergency Medicine CurrentSince May 1, 2025 Accepting new patients

Locations

Dept A T 40379
Atlanta, GA 31192

Dept AT 40379
Atlanta, GA 31192

200 Strahl St
Franklin, TN 37064
Phone (615) 550-5034

1411 W Baddour Pkwy
Lebanon, TN 37087
Phone (615) 443-2500

1400 Willow Dr
Manchester, TN 37355
Phone (931) 409-2194

2000 Church St
Nashville, TN 37236
Phone (615) 284-4672

3841 Green Hills Village Dr
Ste 200
Nashville, TN 37215
Phone (615) 322-6842

719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485

719 Thompson Ln
Ste 30330
Nashville, TN 37204
Phone (615) 936-3871

2835 Highway 231 N
Shelbyville, TN 37160
Phone (931) 685-5433

1801 N Jackson St
Tullahoma, TN 37388
Phone (931) 393-3000

Interoperability endpoints

  • Direct secure messaging: kdettorre21598@direct.vumc.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1154478964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691",
            "telephone_number": "615-322-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 TVC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372320001",
            "telephone_number": "615-322-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 N Jackson St",
            "address_purpose": "LOCATION",
            "city": "Tullahoma",
            "state": "TN",
            "postal_code": "373882201",
            "country_code": "US",
            "telephone_number": "615-875-6415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2835 Highway 231 N",
            "address_purpose": "LOCATION",
            "city": "Shelbyville",
            "state": "TN",
            "postal_code": "371607327",
            "country_code": "US",
            "telephone_number": "615-875-6415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1411 W Baddour Pkwy",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "TN",
            "postal_code": "370872513",
            "country_code": "US",
            "telephone_number": "615-875-6415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DETTORRE",
        "first_name": "KRISTEN",
        "middle_name": "BETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "44731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1513724",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdettorre21598@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 Tvc",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.