Individual provider Active NPI

Kristen Santos-Silva, MSW, LCSW

  • Clinical Social Worker
  • Maryville, TN
National Provider Identifier
1184088775
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6944 Issued in TN
Practice address
210 Simmons St
Maryville, TN 37801-4750
Phone
(865) 970-9800
NPI assigned
Apr 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 21491 MD
Clinical Social Worker 1041C0700X 6944 TN Primary

Addresses

Primary practice location

210 Simmons St
Maryville, TN 37801-4750

Mailing address

PO Box 22301
Knoxville, TN 37933-0301
Phone (315) 489-4512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21491MDMDSocial Worker
6944TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Parkwest Medical Center PastSince Apr 20, 2021 Accepting new patients
Tennessee Vein Center, PLLC PastSince May 24, 2021 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1184088775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22301",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379330301",
            "telephone_number": "315-489-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SIMMONS ST",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014750",
            "telephone_number": "865-970-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS-SILVA",
        "first_name": "KRISTEN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-08",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "21491",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.