Individual provider Active NPI

Kecia Beth McConville, R.D., L.D.N., M.P.H.

  • Metabolic Nutrition Registered Dietitian
  • Knoxville, TN
National Provider Identifier
1407974132
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
1717 Issued in TN
Practice address
220 Fort Sanders West Blvd
Mob 2, Suite 205
Knoxville, TN 37922-3398
Phone
(865) 531-5590
Fax
(865) 531-5596
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X 1717 TN Primary

Addresses

Primary practice location

220 Fort Sanders West Blvd
Mob 2, Suite 205
Knoxville, TN 37922-3398

Mailing address

220 Fort Sanders West Blvd
Mob 2, Suite 205
Knoxville, TN 37922
Phone (865) 531-5590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1717TNMDMental Health Counselor
1710LAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Sanders Regional Medical Center Past Accepting new patients

Organizations & group practices 1

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407974132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 FORT SANDERS WEST BLVD",
            "address_2": "MOB 2, SUITE 205",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37922",
            "telephone_number": "865-531-5590",
            "fax_number": "865-531-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 FORT SANDERS WEST BLVD",
            "address_2": "MOB 2, SUITE 205",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223398",
            "telephone_number": "865-531-5590",
            "fax_number": "865-531-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONVILLE",
        "first_name": "KECIA",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "R.D., L.D.N., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "TN",
            "license": "1717",
            "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.