NPIMap

Individual provider Active NPI

Dwight H Willett, M.D.

  • Family Medicine Physician
  • Kingston, TN
National Provider Identifier
1598746554
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD010763 Issued in TN
Practice address
820 W Race St
Kingston, TN 37763-2120
Phone
(865) 376-3406
Fax
(865) 376-9091
NPI assigned
Nov 8, 2005
Last updated
Apr 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD010763 TN Primary

Addresses

Primary practice location

820 W Race St
Kingston, TN 37763-2120

Mailing address

820 W Race St
Kingston, TN 37763-2120
Phone (865) 376-3406

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address willett.dwight@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
I20041221000778 TN Practitioner - Family Practice 8022076157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Tennessee, HSC, College of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

820 W Race St
Kingston, TN 37763-2120
Phone (865) 376-3406

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD010763TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kingston Family Practice, P.C. Family Medicine CurrentSince Feb 1, 2007 Accepting new patients
Uplands Village Past Accepting new patients
Crossville Medical Investors, LLC Past Accepting new patients
SLF No. 1 LLC Past Accepting new patients
Covenant Medical Group, Inc. Family Medicine Past Accepting new patients
Wartburg Medical Investors LP Past Accepting new patients
Morgan County Health Council Inc Past Accepting new patients

Locations

820 W Race St
Kingston, TN 37763
Phone (865) 376-3406

Interoperability endpoints

  • Direct secure messaging: willett.dwight@covenanthealth.cernerdirect.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Life Care Center of Morgan CountyWartburg, TN, CCN 445239 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2010
Mar 20, 2025
Life Care Center of CrossvilleCrossville, TN, CCN 445167 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2010
Mar 4, 2025
SLF No. 1 LLCCrossville, TN, CCN 445304 Skilled nursing facility Adp of the SNF Feb 24, 2026

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1598746554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 W RACE ST",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377632120",
            "telephone_number": "865-376-3406",
            "fax_number": "865-376-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 W RACE ST",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377632120",
            "telephone_number": "865-376-3406",
            "fax_number": "865-376-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLETT",
        "first_name": "DWIGHT",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD010763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "willett.dwight@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "820 W Race St",
            "city": "Kingston",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377632120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kingston, TN

Sources for this page

Verify at the official NPI Registry.