Individual provider Active NPI

Kellie L Mathewson, NP

  • Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1780983841
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
15629 Issued in TN
Practice address
2030 Falling Waters Rd Ste 325
Knoxville, TN 37922-5893
Phone
(865) 951-1300
NPI assigned
Mar 15, 2011
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 15629 TN Primary
Registered Nurse 163W00000X 112416 TN

Addresses

Primary practice location

2030 Falling Waters Rd Ste 325
Knoxville, TN 37922-5893

Mailing address

2030 Falling Waters Rd Ste 325
Knoxville, TN 37922-5893
Phone (865) 951-1300

Other identifiers 1

IdentifierTypeStateIssuer
1523154MedicaidTN

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110418000258 TN Practitioner - Nurse Practitioner 7315121225 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

420 W Morris Blvd
Suite 400a
Morristown, TN 37813-2262

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
112416TNMDRegistered Nurse
15629TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthstar Physicians, P.C. CurrentSince Apr 1, 2025 Accepting new patients
University Health System Inc CurrentSince Jul 11, 2018 Accepting new patients
Summit Medical Group, PLLC CurrentSince Oct 15, 2013 Accepting new patients
University Health System, Inc CurrentSince Jul 11, 2018 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Mar 29, 2011 Accepting new patients
Summit Medical Group, PLLC CurrentSince Oct 15, 2013 Accepting new patients
Blount Memorial Physician Group, Inc CurrentSince Jan 1, 2011 Accepting new patients
University Health System, Inc Current Accepting new patients
Healthstar Physicians PC CurrentSince Apr 1, 2025 Accepting new patients
Summit View Health Services LLC CurrentSince Aug 22, 2017 Accepting new patients
Summit View Health Services, LLC CurrentSince Aug 22, 2017 Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients
Summit Medical Group,PLLC Past Accepting new patients

Locations

2681 Andersonville Hwy
Ste 102
Clinton, TN 37716
Phone (865) 494-5960

657 E Broadway Blvd
Ste A
Jefferson City, TN 37760
Phone (865) 475-3101

657 E Broadway Blvd
Ste C
Jefferson Cty, TN 37760
Phone (423) 586-1717

10805 Harding Dr
Knoxville, TN 37932
Phone (865) 675-6444

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

12823 Kingston Pike
Knoxville, TN 37934
Phone (865) 862-8100

1928 Alcoa Hwy
Ste B100
Knoxville, TN 37920
Phone (865) 544-6570

2030 Falling Waters Rd
Ste 325
Knoxville, TN 37922
Phone (865) 951-1300

2240 Sutherland Ave
Ste 104
Knoxville, TN 37919
Phone 8659090090 ext. 222

501 20th St
Ste 606
Knoxville, TN 37916
Phone (865) 331-2278

8975 Executive Park Dr
Ste 200
Knoxville, TN 37923
Phone (865) 691-4100

9000 Executive Park Dr
Ste C200
Knoxville, TN 37923
Phone (865) 670-6142

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

458 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5355

463 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5100

420 W Morris Blvd
Ste 400C
Morristown, TN 37813
Phone (423) 586-0443

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kellie.mathewson.1@3525.direct.athenahealth.com

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1780983841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 FALLING WATERS RD STE 325",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379225893",
            "telephone_number": "865-951-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 FALLING WATERS RD STE 325",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379225893",
            "telephone_number": "865-951-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEWSON",
        "first_name": "KELLIE",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-15",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "15629",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "112416",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1523154",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.