Individual provider Active NPI

Judith D Kinzy, M.D.

  • Specialist
  • Knoxville, TN
National Provider Identifier
1770508608
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD24569 Issued in TN
Practice address
4005 Fountain Valley Dr
Suite 350
Knoxville, TN 37918-5327
Phone
(865) 288-1548
Fax
(865) 377-1002
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD24569 TN Primary

Addresses

Primary practice location

4005 Fountain Valley Dr
Suite 350
Knoxville, TN 37918-5327

Mailing address

11440 Parkside Dr
Suite 302
Knoxville, TN 37934-2658
Phone (865) 288-1548

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
I20040106000139 TN Practitioner - Internal Medicine 1951209576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.48 of 100Reported as apm
Quality
86.23
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD24569TNMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Internal Medicine PLLC Specialist CurrentSince Dec 1, 2003 Accepting new patients
Faculty Internal Medicine, PLLC Specialist CurrentSince Dec 1, 2003 Accepting new patients
University Health System Inc Past Accepting new patients

Locations

1924 Alcoa Hwy
#U67
Knoxville, TN 37920
Phone (865) 305-9350

4005 Fountain Valley Dr
Ste 350
Knoxville, TN 37918
Phone (865) 925-9020

1924 Alcoa Hwy
#56
Knoxville, TN 37920
Phone (865) 305-9081

11440 Parkside Dr
Ste 302
Knoxville, TN 37934
Phone (865) 218-9220

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770508608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11440 PARKSIDE DR",
            "address_2": "SUITE 302",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379342658",
            "telephone_number": "865-288-1548",
            "fax_number": "865-377-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 FOUNTAIN VALLEY DR",
            "address_2": "SUITE 350",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379185327",
            "telephone_number": "865-288-1548",
            "fax_number": "865-377-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINZY",
        "first_name": "JUDITH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD24569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.