Individual provider Active NPI

Stephanie Anne Wilkerson, NP

  • Nurse Practitioner
  • Oak Ridge, TN
National Provider Identifier
1659567568
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0000012134 Issued in TN
Practice address
80 Vermont Ave
Oak Ridge, TN 37830-6474
Phone
(865) 482-4078
NPI assigned
Sep 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0000012134 TN Primary

Addresses

Primary practice location

80 Vermont Ave
Oak Ridge, TN 37830-6474

Mailing address

6030 Shannon Valley Farms Blvd
Knoxville, TN 37918-8185
Phone (865) 659-5915

Other identifiers 1

IdentifierTypeStateIssuer
3341206MedicaidTN

Other names 1

  • Miss Stephanie Anne Seymour Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wilkerson.stephanie@covhlth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20071009000815 TN Practitioner - Nurse Practitioner 4688760481 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Tennessee, HSC, College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

80 Vermont Ave
Oak Ridge, TN 37830-6474
Phone (865) 482-4078

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12134TNMDDentist
0000012134TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc CurrentSince Aug 1, 2020 Accepting new patients
Covenant Medical Group, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Hospital Medicine Services of Tennessee PC Nurse Practitioner CurrentSince Jan 1, 2016 Accepting new patients

Locations

8045 Roane Medical Center Dr
Harriman, TN 37748
Phone (865) 316-1000

Dept 888179
Knoxville, TN 37995

550 Fort Loudoun Med Center Dr
Lenoir City, TN 37772
Phone (865) 271-6000

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

80 Vermont Ave
Oak Ridge, TN 37830
Phone (423) 482-4078

990 Oak Ridge Tpke
Oak Ridge, TN 37830
Phone (865) 481-1000

742 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 429-6100

Organizations & group practices 3

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 1

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": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1659567568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6030 SHANNON VALLEY FARMS BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379188185",
            "telephone_number": "865-659-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 VERMONT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306474",
            "telephone_number": "865-482-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "0000012134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3341206",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wilkerson.stephanie@covhlth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "80 Vermont Ave",
            "city": "Oak Ridge",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378306474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SEYMOUR",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.