Individual provider Active NPI

Melissa Ann Guzman, CPNP-PC

  • Pediatric Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1720581390
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APN0000023704 Issued in TN
Practice address
10857 Hardin Valley Rd
Knoxville, TN 37932-1410
Phone
(865) 690-2682
Fax
(866) 529-5509
NPI assigned
Mar 9, 2018
Last updated
Mar 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APN0000023704 TN Primary

Addresses

Primary practice location

10857 Hardin Valley Rd
Knoxville, TN 37932-1410

Mailing address

11029 Eagle Creek LN
Knoxville, TN 37932-1472
Phone (865) 228-4733

Other practice location 1

1400 Dutch Valley Dr
Knoxville, TN 37918-1424
Phone (865) 689-1122

Other practice location 2

130 Independence Ln
LA Follette, TN 37766-3073
Phone (423) 562-1705

Other identifiers 1

IdentifierTypeStateIssuer
Q045208MedicaidTN

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

State licenses

LicenseStateTypeSpecialty
APN0000023704TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Children's Primary Care Center, Inc. Pediatrics CurrentSince Dec 16, 2020 Accepting new patients
Mountain View Pediatrics Past Accepting new patients
North Hall Pediatrics PC Past Accepting new patients

Locations

10857 Hardin Valley Rd
Knoxville, TN 37932
Phone (865) 690-2682

1400 Dutch Valley Dr
Knoxville, TN 37918
Phone (865) 689-1122

Interoperability endpoints

  • Direct secure messaging: melissa.guzman.p1@direct.chetn.nextgenshare.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1720581390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11029 EAGLE CREEK LN",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321472",
            "telephone_number": "865-228-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10857 HARDIN VALLEY RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321410",
            "telephone_number": "865-690-2682",
            "fax_number": "866-529-5509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Dutch Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379181424",
            "country_code": "US",
            "telephone_number": "865-689-1122",
            "fax_number": "866-340-3781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 Independence Ln",
            "address_purpose": "LOCATION",
            "city": "LA Follette",
            "state": "TN",
            "postal_code": "377663073",
            "country_code": "US",
            "telephone_number": "423-562-1705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-09",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "APN0000023704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q045208",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 4, 2020; 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.