Active NPI
Khristen Noel Qualls, APN
- Family Nurse Practitioner
- Chattanooga, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 34750
- Practice address
- 2525 Desales Ave Ste F1009
Chattanooga, TN 37404-1161 - Phone
- (423) 624-5200
- Fax
- (423) 697-2320
- NPI assigned
- Nov 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 34750 | TN | Primary |
Addresses
Primary practice location
2525 Desales Ave Ste F1009
Chattanooga, TN 37404-1161
Mailing address
2525 Desales Ave Ste F1009
Chattanooga, TN 37404-1161
Phone (423) 624-5200
Other practice location 1
2418 Ashmore Ave
Chattanooga, TN 37415-6398
Phone (615) 806-4063
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
419 N Market St
Suite 100
Chattanooga, TN 37405-3974
Phone (423) 414-3012
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34750 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiovascular Group, PC | Current | Accepting new patients | |
| Memorial Health Care System, Inc. | Current | Accepting new patients | |
| Memorial Health Care System Inc. | Current | Accepting new patients | |
| Hospital Medicine Services of TN, LLC | Family | Current | Accepting new patients |
Locations
2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426
2501 Citico Ave
Chattanooga, TN 37404
Phone (423) 697-2318
2525 Desales Ave
Ste F1009
Chattanooga, TN 37404
Phone (423) 624-5200
941 Spring Creek Rd
East Ridge, TN 37412
Phone (423) 855-3255
2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500
2300 Patterson St
#M
Nashville, TN 37203
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Murfreesboro, TN
- NPI 1366644361
-
- General Acute Care Hospital
- Chattanooga, TN
- NPI 1255428736
-
- Cardiovascular Disease Physician
- Chattanooga, TN
- NPI 1912906181
-
- Cardiovascular Disease Physician
- Chattanooga, TN
- NPI 1851695480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733961600000",
"number": "1316712946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 DESALES AVE STE F1009",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374041161",
"telephone_number": "423-624-5200",
"fax_number": "423-697-2320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 DESALES AVE STE F1009",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374041161",
"telephone_number": "423-624-5200",
"fax_number": "423-697-2320"
}
],
"practiceLocations": [
{
"address_1": "2418 Ashmore Ave",
"address_purpose": "LOCATION",
"city": "Chattanooga",
"state": "TN",
"postal_code": "374156398",
"country_code": "US",
"telephone_number": "615-806-4063",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "QUALLS",
"first_name": "KHRISTEN",
"middle_name": "NOEL",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-27",
"last_updated": "2024-12-12",
"certification_date": "2024-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "34750",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.