Organization Active NPI

Knoxville Gastrointestinal Specialists, PC

  • Gastroenterology Physician
  • Knoxville, TN
National Provider Identifier
1194910919
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
KNOXVILLE GASTROINTESTINAL SPECIALISTS, PC
Practice address
1819 W Clinch Ave
Suite 212
Knoxville, TN 37916-2434
Phone
(865) 523-6418
NPI assigned
Sep 14, 2007
Last updated
Feb 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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

Authorized official

Name
Mrs. Kristi L Breeden
Title
Office MGR
Phone
(865) 523-6418

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

1819 W Clinch Ave
Suite 212
Knoxville, TN 37916-2434

Mailing address

1819 W Clinch Ave
Suite 212
Knoxville, TN 37916-2434
Phone (865) 523-6418

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110705000079 TN Part B Supplier - Clinic/Group Practice 5991983454 Receives reassigned benefits from 7 practitioners
Practice locations: Knoxville, TN

National Provider Directory

National Provider Directory

Locations

2001 Laurel Ave
Ste 603
Knoxville, TN 37916
Phone (865) 523-6418

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328227200000",
    "number": "1194910919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 W CLINCH AVE",
            "address_2": "SUITE 212",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162434",
            "telephone_number": "865-523-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 W CLINCH AVE",
            "address_2": "SUITE 212",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162434",
            "telephone_number": "865-523-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOXVILLE GASTROINTESTINAL SPECIALISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2012-02-03",
        "status": "A",
        "authorized_official_last_name": "BREEDEN",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "865-523-6418",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "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 Feb 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.