Individual provider Active NPI

Grady McMillen

  • Psychiatric/Mental Health Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1528839974
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
38010 Issued in TN
Practice address
1515 Saint Mary St
Knoxville, TN 37917-4503
Phone
(865) 637-9711
NPI assigned
Jan 15, 2024
Last updated
Apr 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 38010 TN Primary
Registered Nurse 163W00000X 154330 TN

Addresses

Primary practice location

1515 Saint Mary St
Knoxville, TN 37917-4503

Mailing address

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

Other practice location 1

410 Clinchview Dr
Lenoir City, TN 37771-7500
Phone (865) 556-0571

Other practice location 2

1704 E Broadway Ave
Maryville, TN 37804-2916
Phone (865) 681-6990

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
I20250814003860 TN Practitioner - Nurse Practitioner 5991968091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

205 W Springdale Ave
Knoxville, TN 37917-5158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
154330TNMDRegistered Nurse
38010TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Helen Ross McNabb Center CurrentSince Jun 1, 2025 Accepting new patients

Locations

1515 Saint Mary St
Knoxville, TN 37917
Phone (865) 213-1550

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

5310 Ball Camp Pike
Knoxville, TN 37921
Phone (865) 262-8208

1704 E Broadway Ave
Maryville, TN 37804
Phone (865) 681-6990

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, 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": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1528839974",
    "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": "1515 SAINT MARY ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379174503",
            "telephone_number": "865-637-9711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 Clinchview Dr",
            "address_purpose": "LOCATION",
            "city": "Lenoir City",
            "state": "TN",
            "postal_code": "377717500",
            "country_code": "US",
            "telephone_number": "865-556-0571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1704 E Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "TN",
            "postal_code": "378042916",
            "country_code": "US",
            "telephone_number": "865-681-6990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMILLEN",
        "first_name": "GRADY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-15",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "38010",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "154330",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.