Individual provider Active NPI

Katelyn Marie Liles, FNP-BC

  • Family Nurse Practitioner
  • Oak Ridge, TN
National Provider Identifier
1740574508
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15792 Issued in TN
Practice address
801 Oak Ridge Turnpike
Oak Ridge, TN 37830-6916
Phone
(865) 482-4088
Fax
(866) 674-2033
NPI assigned
Jun 8, 2011
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 15792 TN Primary

Addresses

Primary practice location

801 Oak Ridge Turnpike
Oak Ridge, TN 37830-6916

Mailing address

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

Other practice location 1

2221 Jacksboro Pike, Suite C-4
LaFollette, TN 37766-3007
Phone (423) 566-3488

Other practice location 2

2130 N. Charles Seivers Blvd, Suite 4
Clinton, TN 37716-6705
Phone (865) 457-4044

Other practice location 3

1705 Roane State Hwy
Harriman, TN 37748-8306
Phone (865) 316-5001

Other identifiers 1

IdentifierTypeStateIssuer
1525186MedicaidTN

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
East Tennessee Children's Primary Care Center, Inc. Family Past Accepting new patients

Organizations & group practices 1

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": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1740574508",
    "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": "801 OAK RIDGE TURNPIKE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306916",
            "telephone_number": "865-482-4088",
            "fax_number": "866-674-2033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2221 Jacksboro Pike, Suite C-4",
            "address_purpose": "LOCATION",
            "city": "LaFollette",
            "state": "TN",
            "postal_code": "377663007",
            "country_code": "US",
            "telephone_number": "423-566-3488",
            "fax_number": "866-722-3453",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2130 N. Charles Seivers Blvd, Suite 4",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "TN",
            "postal_code": "377166705",
            "country_code": "US",
            "telephone_number": "865-457-4044",
            "fax_number": "866-699-4833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1705 Roane State Hwy",
            "address_purpose": "LOCATION",
            "city": "Harriman",
            "state": "TN",
            "postal_code": "377488306",
            "country_code": "US",
            "telephone_number": "865-316-5001",
            "fax_number": "865-376-3713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILES",
        "first_name": "KATELYN",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "15792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1525186",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.