Individual provider Active NPI

Deena Cantrill

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1194175083
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21365 Issued in TN
Practice address
1915 White Ave
Knoxville, TN 37916
Phone
(865) 331-1720
NPI assigned
Jun 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 178375 TN
Family Nurse Practitioner 363LF0000X 21365 TN Primary

Addresses

Primary practice location

1915 White Ave
Knoxville, TN 37916

Mailing address

1915 White Ave
Knoxville, TN 37916-2300
Phone (865) 331-1720

Other practice location 1

1787 Veterans Blvd
Suite 101
Sevierville, TN 37862-6945
Phone (865) 428-2773

Other identifiers 1

IdentifierTypeStateIssuer
Q028950MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cantrill.deena@covenanthealth.cernerdirect.com

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
I20170411002204 TN Practitioner - Nurse Practitioner 2163708827 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Twelvestone Infusion Centers LLCGroup PAC ID 6800151424, 64 clinicians

Practice addresses (Care Compare)

8880 Cedar Springs LN
Suite 103
Knoxville, TN 37923-5400
Phone (844) 893-0012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178375TNMDRegistered Nurse
21365TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thompson Oncology Group CurrentSince Oct 25, 2018 Accepting new patients
Twelvestone Infusion Centers LLC CurrentSince Mar 1, 2020 Accepting new patients
Niteowl Pediatrics, LLC Family PastSince Mar 1, 2020 Accepting new patients

Locations

Dept 888078
Knoxville, TN 37995

1915 White Ave
Knoxville, TN 37916
Phone (423) 977-1065

8880 Cedar Springs Ln
Ste 103
Knoxville, TN 37923

352 W Northfield Blvd
Ste 4C
Murfreesboro, TN 37129
Phone (615) 895-6977

Interoperability endpoints

  • Direct secure messaging: cantrill.deena@covenanthealth.cernerdirect.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.

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1194175083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 WHITE AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162300",
            "telephone_number": "865-331-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 WHITE AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37916",
            "telephone_number": "865-331-1720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1787 Veterans Blvd",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Sevierville",
            "state": "TN",
            "postal_code": "378626945",
            "country_code": "US",
            "telephone_number": "865-428-2773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANTRILL",
        "first_name": "DEENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "178375",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q028950",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cantrill.deena@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1915 White Ave",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.