Individual provider Active NPI

Katelyn Elizabeth Dantzler, NP

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1609253152
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19999 Issued in TN
Practice address
2018 Clinch Ave, South Tower
2ND Floor
Knoxville, TN 37916
Phone
(865) 971-7400
Fax
(865) 246-7561
NPI assigned
May 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19999 TN Primary

Addresses

Primary practice location

2018 Clinch Ave, South Tower
2ND Floor
Knoxville, TN 37916

Mailing address

PO Box 15004
Knoxville, TN 37901-5004
Phone (865) 541-8895

Other identifiers 1

IdentifierTypeStateIssuer
Q019292MedicaidTN

Other names 1

  • Katelyn Elizabeth Kirk Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Knoxville Hma Physician Management, LLC Family Past Accepting new patients
East Tennessee Children'S Hospital Association, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4694/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1609253152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15004",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379015004",
            "telephone_number": "865-541-8895",
            "fax_number": "865-633-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 CLINCH AVE, SOUTH TOWER",
            "address_2": "2ND FLOOR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37916",
            "telephone_number": "865-971-7400",
            "fax_number": "865-246-7561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTZLER",
        "first_name": "KATELYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-05",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "19999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q019292",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "KIRK",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.