Individual provider Active NPI

Kristine Bedell Mongan, PT, DPT

  • Physical Therapist
  • Knoxville, TN
National Provider Identifier
1740653435
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305209487 Issued in VA
Practice address
4905 N Broadway St
Knoxville, TN 37918-2315
Phone
(865) 689-8299
Fax
(865) 689-9804
NPI assigned
Nov 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305209487 VA Primary

Addresses

Primary practice location

4905 N Broadway St
Knoxville, TN 37918-2315

Mailing address

4905 N Broadway St
Knoxville, TN 37918-2315
Phone (865) 689-8299

Other names 1

  • Kristine Bedell Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160818000692 TN Practitioner - Physical Therapist in Private Practice 4880989607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Tennessee Spine and Sport IncGroup PAC ID 8820013139, 41 clinicians

Practice addresses (Care Compare)

10966 Spring Bluff Way
Knoxville, TN 37932-1793
Phone (865) 599-5323

4905 N Broadway
Knoxville, TN 37918-2315
Phone (865) 689-8299

501 Adesa Blvd
Suite A140
Lenoir City, TN 37771-6720
Phone (865) 333-1461

7240 Kingston Pike
Suite 160
Knoxville, TN 37919-5615
Phone (865) 691-5020

7430 Chapman Hwy
Knoxville, TN 37920-6614
Phone (865) 214-6647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305209487VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Spine & Sport Inc Physical Therapist CurrentSince Jun 27, 2016 Accepting new patients

Locations

7430 Chapman Hwy
Knoxville, TN 37920
Phone (865) 214-6647

10966 Spring Bluff Way
Knoxville, TN 37932
Phone (865) 599-5323

7240 Kingston Pike
Ste 160
Knoxville, TN 37919
Phone (602) 762-0756

4905 N Broadway St
Knoxville, TN 37918
Phone (865) 689-8299

150 N Martinwood Rd
Ste 402
Knoxville, TN 37923
Phone (865) 691-5020

142 W End Ave
Knoxville, TN 37934
Phone (865) 249-7566

142 Fairbanks Rd
Ste 150
Oak Ridge, TN 37830
Phone (865) 888-5431

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1740653435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 N BROADWAY ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379182315",
            "telephone_number": "865-689-8299",
            "fax_number": "865-689-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 N BROADWAY ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379182315",
            "telephone_number": "865-689-8299",
            "fax_number": "865-689-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGAN",
        "first_name": "KRISTINE",
        "middle_name": "BEDELL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305209487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "BEDELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 25, 2025; 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.