Christenberry Clinic, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD5549 Issued in TN

Legal business name

CHRISTENBERRY CLINIC, PC

Practice address

1318 W Clinch Ave
Knoxville, TN 37916-2612

Phone

(865) 522-5155

Fax

(865) 522-5157

NPI assigned

Aug 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth William Christenberry Jr., MDNPI 1780783860

Title

President

Phone

(865) 522-5155

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth William Christenberry, MD

  • Specialist
  • Knoxville, TN
  • NPI 1780783860
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185926400000",
    "number": "1629268925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 W CLINCH AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162612",
            "telephone_number": "865-522-5155",
            "fax_number": "865-522-5157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 W CLINCH AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162612",
            "telephone_number": "865-522-5155",
            "fax_number": "865-522-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTENBERRY CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-01",
        "last_updated": "2007-08-01",
        "status": "A",
        "authorized_official_last_name": "CHRISTENBERRY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-522-5155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD5549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3375360",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dani Madison Chowen
• Shannon Lyn Chrisco
• Janey Lynn Chrisman, NP
• Branden Gage Christ Glover, LMT
• Nathaniel Casey Christakis
• Kenneth William Christenberry, MD
• Lise Christensen, M.D.
• Timothy Christensen
• Regan C. Christenson, APN
• Deborah Jones Christiansen, MD

• Specialist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.