Individual provider Active NPI

Katherine Whaley

  • Physician Assistant
  • Vonore, TN
National Provider Identifier
1154818672
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3546 Issued in TN
Practice address
110 Deer Xing
Vonore, TN 37885-2133
Phone
(423) 884-1925
Fax
(423) 884-1926
NPI assigned
Apr 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3546 TN Primary

Addresses

Primary practice location

110 Deer Xing
Vonore, TN 37885-2133

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842

Other identifiers 1

IdentifierTypeStateIssuer
Q036723MedicaidTN

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
I20180806001648 TN Practitioner - Physician Assistant 9133477284 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blount Memorial Physician Group IncGroup PAC ID 6406844174, 252 clinicians

Practice addresses (Care Compare)

110 Deer Crossings
Vonore, TN 37885-2133
Phone (423) 884-1925

405 BMH Physicians Office BLDG
Maryville, TN 37804-5807
Phone (865) 238-6430

425 BMH Physicians
Office BLDG
Maryville, TN 37804-5807
Phone (865) 980-5260

463 BMH Physician
Office BLDG
Maryville, TN 37804-5807
Phone (865) 980-5100

Hospital & facility affiliations

  • Blount Memorial Hospital Hospital, Maryville, TN, CCN 440011

Merit-based Incentive Payment System (MIPS)

Final score
77.77 of 100Reported as group
Quality
58.61
Promoting interoperability
92
Improvement activities
40
Cost
73.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3546TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc CurrentSince May 14, 2018 Accepting new patients
Covenant Medical Group, Inc. Physician Assistant CurrentSince May 14, 2018 Accepting new patients

Locations

266 Joule St
Alcoa, TN 37701
Phone (865) 984-3864

9330 Park West Blvd
Ste 402
Knoxville, TN 37923
Phone (865) 690-3003

Dept 888179
Knoxville, TN 37995

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

Interoperability endpoints

  • Direct secure messaging: kwhaley864525@direct.ghs.myhfn.org
  • Direct secure messaging: katherine.cozzi.p1@direct.bmpg.nextgenshare.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 1

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": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1154818672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 DEER XING",
            "city": "VONORE",
            "state": "TN",
            "postal_code": "378852133",
            "telephone_number": "423-884-1925",
            "fax_number": "423-884-1926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEY",
        "first_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-19",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q036723",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vonore, TN

Sources for this page

Verify at the official NPI Registry.