Individual provider Active NPI

Karen R Whalen, APRN, BC

  • Family Nurse Practitioner
  • Clinton, TN
National Provider Identifier
1447433750
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13059 Issued in TN
Practice address
102 S Charles G Seivers Blvd
Clinton, TN 37716-3916
Phone
(865) 457-4702
NPI assigned
Dec 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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 13059 TN Primary

Addresses

Primary practice location

102 S Charles G Seivers Blvd
Clinton, TN 37716-3916

Mailing address

102 S Charles G Seivers Blvd
Clinton, TN 37716-3916
Phone (865) 457-4702

Other practice location 1

1299 Oak Ridge Tpke
Oak Ridge, TN 37830-6406
Phone (865) 294-0198

Other identifiers 1

IdentifierTypeStateIssuer
1522207MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address whalen.karen@covenanthealth.cernerdirect.com

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
I20110105000850 TN Practitioner - Nurse Practitioner 5092894162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

102 S Charles G Seivers Blvd
Clinton, TN 37716-3916
Phone (865) 457-4702

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13059TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc CurrentSince Jan 21, 2020 Accepting new patients
Covenant Medical Group, Inc. CurrentSince Jan 21, 2020 Accepting new patients

Locations

102 S Seivers Blvd
Clinton, TN 37716
Phone (865) 457-4702

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1447433750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S CHARLES G SEIVERS BLVD",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377163916",
            "telephone_number": "865-457-4702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S CHARLES G SEIVERS BLVD",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377163916",
            "telephone_number": "865-457-4702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1299 Oak Ridge Tpke",
            "address_purpose": "LOCATION",
            "city": "Oak Ridge",
            "state": "TN",
            "postal_code": "378306406",
            "country_code": "US",
            "telephone_number": "865-294-0198",
            "fax_number": "865-483-8887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHALEN",
        "first_name": "KAREN",
        "middle_name": "R",
        "credential": "APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-10",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "13059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1522207",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "whalen.karen@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "102 S Charles G Seivers Blvd",
            "city": "Clinton",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377163916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clinton, TN

Sources for this page

Verify at the official NPI Registry.