Keaton Cupp, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

35647 Issued in TN

Practice address

4611 Asheville Hwy
Knoxville, TN 37914-3615

Phone

(865) 246-2104

NPI assigned

May 1, 2023

Last updated

Feb 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MJ Mental Health, LLCGroup PAC ID 2163878513, 9 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MJ Mental Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Knoxville, TN
  • NPI 1578348256
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1376231084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5777",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378025777",
            "telephone_number": "865-246-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 ASHEVILLE HWY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379143615",
            "telephone_number": "865-246-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUPP",
        "first_name": "KEATON",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-01",
        "last_updated": "2024-02-15",
        "certification_date": "2024-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "35647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa McGrady Cunningham, MHS, OTR/L, CHT
• Meredith Cunningham, MS, CCC-SLP
• Rose Anna Cunningham, FNP
• Stephanie Nicole Cunningham, O.D.
• James Daniel Cupp, PTA
• Melissa Cupp, LCSW
• Paige M Cupp
• Cura Partners, LLC (Addus HomeCare)
• Curascript Infusion Pharmacy, Inc.
• Andra Cureton-Hutchins, NP

• Psychiatric/Mental Health Nurse Practitioner in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.

Verify at the official NPI Registry.