Individual provider Active NPI

Khristen Noel Qualls, APN

  • Family Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1316712946
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
34750 Issued in TN
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

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240910002281 TN Practitioner - Nurse Practitioner 4880134469 Reassigns benefits to 3 organizations

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
Crossroads Urgent Care PLLCGroup PAC ID 8325117484, 181 clinicians

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

LicenseStateTypeSpecialty
34750TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Group, PC Current Accepting new patients
Memorial Health Care System, Inc. CurrentSince Dec 16, 2024 Accepting new patients
Memorial Health Care System Inc. Current Accepting new patients
Hospital Medicine Services of TN, LLC Family CurrentSince May 1, 2025 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.

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

Verify at the official NPI Registry.