NPIMap

Individual provider Active NPI

Livana Theresa Koznesoff, MD

  • Vascular Neurology Physician
  • Knoxville, TN
National Provider Identifier
1548729411
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
70372 Issued in TN
Practice address
501 20TH St Ste 503
Knoxville, TN 37916-1832
Phone
(865) 331-4321
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 70372 TN
Vascular Neurology Physician 2084V0102X 70372 TN Primary

Addresses

Primary practice location

501 20TH St Ste 503
Knoxville, TN 37916-1832

Mailing address

501 20TH St Ste 503
Knoxville, TN 37916-1832
Phone (865) 331-4321

Other identifiers 1

IdentifierTypeStateIssuer
Q092425MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address koznesoff.livana@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240820002844 TN Practitioner - Neurology 6709119076 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians
Parkwest Medical CenterGroup PAC ID 8527965417, 58 clinicians

Practice addresses (Care Compare)

501 20TH St
Suite 503
Knoxville, TN 37916-1832
Phone (865) 541-4321

9352 Park W Blvd
Knoxville, TN 37923-4325
Phone (865) 694-5700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc CurrentSince Jul 15, 2024 Accepting new patients
Covenant Medical Group, Inc. Neurology CurrentSince Jul 15, 2024 Accepting new patients
Parkwest Medical Center CurrentSince Dec 6, 2024 Accepting new patients
Parkwest Medical Center Past Accepting new patients

Locations

501 20th St
Ste 503
Knoxville, TN 37916
Phone (865) 331-4321

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

Dept 888179
Knoxville, TN 37995

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

Interoperability endpoints

  • Direct secure messaging: lkoznesoff26259@albanymed.direct-ci.com
  • Direct secure messaging: koznesoff.livana@covenanthealth.cernerdirect.com

Organizations & group practices 4

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 5

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1548729411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 20TH ST STE 503",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161832",
            "telephone_number": "865-331-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 20TH ST STE 503",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161832",
            "telephone_number": "865-331-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZNESOFF",
        "first_name": "LIVANA",
        "middle_name": "THERESA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "70372",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "TN",
            "license": "70372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q092425",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "koznesoff.livana@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "501 20th St Ste 503",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379161832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.