Individual provider Active NPI

Kristie Williams Johnston, AU.D.

  • Audiologist
  • Knoxville, TN
National Provider Identifier
1174752026
Registry record updated Jul 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
0000001112 Issued in TN
Practice address
2100 W Clinch Ave Ste 410
Knoxville, TN 37916-2287
Phone
(865) 521-6005
NPI assigned
Jul 13, 2009
Last updated
Jul 13, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 0000001112 TN Primary

Addresses

Primary practice location

2100 W Clinch Ave Ste 410
Knoxville, TN 37916-2287

Mailing address

12719 Ackley Cir
Knoxville, TN 37934-0849
Phone (865) 671-8689

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210517001031 TN Practitioner - Qualified Audiologist 0042629354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Tennessee, HSC, College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evans Innovations, IncGroup PAC ID 3375687924, 3 clinicians

Practice addresses (Care Compare)

9724 Kingston Pike
Suite 205
Knoxville, TN 37922-3347
Phone (865) 694-9870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000001112TNMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Innovations, Inc CurrentSince Apr 29, 2021 Accepting new patients
Evans Innovations, LLC PastSince Apr 29, 2021 Accepting new patients

Locations

9724 Kingston Pike
Ste 205
Knoxville, TN 37922
Phone (865) 694-9870

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247443200000",
    "number": "1174752026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12719 ACKLEY CIR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379340849",
            "telephone_number": "865-671-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W CLINCH AVE STE 410",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162287",
            "telephone_number": "865-521-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "KRISTIE",
        "middle_name": "WILLIAMS",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-13",
        "last_updated": "2009-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TN",
            "license": "0000001112",
            "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 Jul 13, 2009; 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.