Individual provider Active NPI

Justin Edwin Horner, DO

  • Internal Medicine Physician
  • Knoxville, TN
National Provider Identifier
1538747993
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5547 Issued in TN
Practice address
6473 Kingston Pike
Knoxville, TN 37919-4832
Phone
(865) 909-0090
NPI assigned
Mar 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5547 TN Primary

Addresses

Primary practice location

6473 Kingston Pike
Knoxville, TN 37919-4832

Mailing address

6473 Kingston Pike
Knoxville, TN 37919-4832
Phone (865) 909-0090

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240822004408 TN Practitioner - Internal Medicine 7113309337

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1900 N Winston Rd
Suite 501
Knoxville, TN 37919-3605

3030 Northwest Expressway
Suite 1000
Oklahoma City, OK 73112-5468

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5547TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Statcare Inpatient LLC Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients
Statcare Outpatient, LLC Internal Medicine PastSince Nov 10, 2024 Accepting new patients

Locations

1901 Clinch Ave
Knoxville, TN 37916
Phone (865) 331-1111

1900 N Winston Rd
Ste 501
Knoxville, TN 37919
Phone (865) 909-0090

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d924d991-43c4-4c48-b322-4525ba4c2001/
  • Direct secure messaging: justin.horner.1@15627.direct.athenahealth.com

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 7

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1538747993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6473 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194832",
            "telephone_number": "865-909-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6473 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194832",
            "telephone_number": "865-909-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNER",
        "first_name": "JUSTIN",
        "middle_name": "EDWIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "5547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.