Individual provider Active NPI

Bethany Gillis, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1447404298
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
13739 Issued in TN
Practice address
205 W Springdale Ave
Knoxville, TN 37917-5158
Phone
(865) 637-9711
NPI assigned
Nov 6, 2008
Last updated
Mar 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 13739 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 13739 TN Primary

Addresses

Primary practice location

205 W Springdale Ave
Knoxville, TN 37917-5158

Mailing address

200 Tech Center Dr
Knoxville, TN 37912-2747
Phone (865) 637-9711

Other identifiers 1

IdentifierTypeStateIssuer
1512108MedicaidTN

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
I20081218000156 TN Practitioner - Nurse Practitioner 1456413913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Helen Ross McNabb CenterGroup PAC ID 1658278809, 40 clinicians

Practice addresses (Care Compare)

205 W Springdale Ave
Knoxville, TN 37917-5158
Phone (865) 637-9711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Helen Ross McNabb Center CurrentSince Apr 25, 2022 Accepting new patients
Ultacare Medical PLLC Psychiatric/Mental Health Past Accepting new patients

Locations

200 Tech Center Dr
Knoxville, TN 37912
Phone (865) 367-9711

201 W Springdale Ave
Knoxville, TN 37917
Phone (865) 329-9173

205 W Springdale Ave
Knoxville, TN 37917
Phone (865) 312-7278

600 Arthur St
Knoxville, TN 37921
Phone (865) 523-8695

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1447404298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TECH CENTER DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379122747",
            "telephone_number": "865-637-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W SPRINGDALE AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379175158",
            "telephone_number": "865-637-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "BETHANY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "13739",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "13739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1512108",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.