Kaci Allison Oetjen

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6890 Issued in TN

Practice address

7305 Jarnigan Rd Ste 260
Chattanooga, TN 37421-4895

Phone

(423) 708-5050

Fax

(423) 708-5055

NPI assigned

Jun 17, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, TN2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Vein Center PLLCGroup PAC ID 2264727627, 16 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.37 of 100Reported as group

Quality

88.37

Promoting interoperability

100

Improvement activities

40

Cost

70.95

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Legacy Vein Center PLLC

  • Vascular Surgery Physician
  • Johnson City, TN
  • NPI 1477972933
  Medicare reassignment Care Compare group NPD
• University Surgical Associates of Athens

  • Specialist
  • Watkinsville, GA
  • NPI 1861500183
  Medicare reassignment
• Legacy Vein Center PLLC

  • Durable Medical Equipment & Medical Supplies
  • Sevierville, TN
  • NPI 1770158859
  NPD

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1194393918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N STATE OF FRANKLIN RD STE 103",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046063",
            "telephone_number": "423-328-0163",
            "fax_number": "423-491-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7305 JARNIGAN RD STE 260",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214895",
            "telephone_number": "423-708-5050",
            "fax_number": "423-708-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OETJEN",
        "first_name": "KACI",
        "middle_name": "ALLISON",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "10703",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josephine Pauline Odom, CERTIFIED HAIR LOSS
• Ruby Amelia Odum, PHARMD
• Patrick Oellerich, MFTI
• William F Oellerich, MD
• Kathryn Tully Oelsner, MD
• Paula Offutt, ORT/L
• Rae'Ven Nicole Offutt
• Sadie Offutt
• Mary Elaine Ogden, FNP
• Angela D Ogle, NP

• Physician Assistant in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.