Katelyn Danielle Wackenhut, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3274 Issued in TN

Practice address

3601 The Vanderbilt Clinic
Nashville, TN 37232-6035

Phone

(615) 322-5000

NPI assigned

Jan 20, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Katelyn Danielle Cresswell Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL, TN, VA, MI4 enrollments

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 4

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Vanderbilt University Medical Center

  dba Vanderbilt Medical Group

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1104202761

  Emergency Medicine

  Medicare reassignment NPD
• Caberfae Emergency Group, P.C.

  • Emergency Medicine Physician
  • Cadillac, MI
  • NPI 1447932504
  Medicare reassignment NPD
• Hawk Emergency Group, P.C.

  • Emergency Medicine Physician
  • Charlevoix, MI
  • NPI 1073295135
  Medicare reassignment NPD
• Interlochen Emergency Group, P.C.

  • Emergency Medicine Physician
  • Traverse City, MI
  • NPI 1336821495
  Medicare reassignment NPD
• Hardin Emergency Group LLC

  • Emergency Medicine Physician
  • Savannah, TN
  • NPI 1972850477
  Medicare reassignment
• Havely Springs Emergency Group, PC

  • Emergency Medicine Physician
  • Springfield, TN
  • NPI 1770090110
  Medicare reassignment
• Tri-Cities Observation Services, PC

  • Emergency Medicine Physician
  • Johnson City, TN
  • NPI 1154860146
  Medicare reassignment
• Tri-Cities Regional Emergency Physicians, PC

  • Emergency Medicine Physician
  • Johnson City, TN
  • NPI 1063950046
  Medicare reassignment
• Northwest Alabama Emergency Medicine LLC

  • Emergency Medicine Physician
  • Florence, AL
  • NPI 1639692767
  Medicare reassignment
• Western Virginia Regional Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Norton, VA
  • NPI 1386183028
  Medicare reassignment

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1558728626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 THE VANDERBILT CLINIC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372326035",
            "telephone_number": "615-322-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046035",
            "country_code": "US",
            "telephone_number": "423-431-6111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 Marengo St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "AL",
            "postal_code": "356306033",
            "country_code": "US",
            "telephone_number": "256-768-9191",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1211 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372326035",
            "country_code": "US",
            "telephone_number": "615-322-0160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WACKENHUT",
        "first_name": "KATELYN",
        "middle_name": "DANIELLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "3274",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006145",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwackenhut798715@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "1211 Medical Center Dr",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372326035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "CRESSWELL",
            "middle_name": "DANIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dustin Vukovic, D.C.
• Punit Vyas, MD
• W Garrison Strickland MD, PC
• W Scott West, MD PLLC
• Wa Peace PLLC
• Inez Davis Waddell, R.D.H.
• Julia Waddell
• Kendall Waddey
• Wade Nursing Registry of Nashville, Inc.
• Theodore B. Wade, PA-C

• Physician Assistant in Nashville, TN
• Providers in Nashville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.