Individual provider Active NPI

Christian Louis Traynelis, MD

  • Urology Physician
  • Sevierville, TN
National Provider Identifier
1720069867
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD34366 Issued in TN
Practice address
744 Middle Creek Road
Suite 208
Sevierville, TN 37862
Phone
(865) 446-9675
Fax
(865) 446-9701
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD34366 TN Primary

Addresses

Primary practice location

744 Middle Creek Road
Suite 208
Sevierville, TN 37862

Mailing address

744 Middle Creek Road
Suite 208
Sevierville, TN 37862
Phone (865) 446-9675

Other identifiers 1

IdentifierTypeStateIssuer
3874815MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Traynelis.Christian@covenanthealth.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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060719000050 TN Practitioner - Urology 1052324951 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD34366TNMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc CurrentSince Aug 1, 2006 Accepting new patients
Covenant Medical Group, Inc. Urology CurrentSince Aug 1, 2006 Accepting new patients
Valley Urology, L.L.C. Urology Past Accepting new patients

Locations

Dept 888179
Knoxville, TN 37995

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

629 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 453-9980

744 Middle Creek Rd
Ste 208
Sevierville, TN 37862
Phone (865) 446-9675

Interoperability endpoints

  • Direct secure messaging: traynelis.christian@covenanthealth.cernerdirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1720069867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 MIDDLE CREEK ROAD",
            "address_2": "SUITE 208",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "37862",
            "telephone_number": "865-446-9675",
            "fax_number": "865-446-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 MIDDLE CREEK ROAD",
            "address_2": "SUITE 208",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "37862",
            "telephone_number": "865-446-9675",
            "fax_number": "865-446-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAYNELIS",
        "first_name": "CHRISTIAN",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "MD34366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3874815",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Traynelis.Christian@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "744 Middle Creek Road",
            "address_2": "Suite 208",
            "city": "Sevierville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sevierville, TN

Sources for this page

Verify at the official NPI Registry.