Individual provider Active NPI

Krystel D Hatfield, FNP-BC

  • Family Nurse Practitioner
  • Maryville, TN
National Provider Identifier
1790108975
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18287 Issued in TN
Practice address
907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015
Phone
(865) 980-5100
Fax
(865) 980-5105
NPI assigned
Jan 24, 2014
Last updated
Jun 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18287 TN Primary
Registered Nurse 163W00000X 179786 TN

Addresses

Primary practice location

907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015

Mailing address

103 W Broadway Ave
Maryville, TN 37801-4703
Phone (865) 273-1752

Other identifiers 1

IdentifierTypeStateIssuer
Q005447MedicaidTN

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
I20140430001723 TN Practitioner - Nurse Practitioner 7113150053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Blount Memorial Physician Group IncGroup PAC ID 6406844174, 252 clinicians

Practice addresses (Care Compare)

907 E Lamar Alexander Pkwy
Maryville, TN 37804-5015
Phone (865) 980-5082

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.77 of 100Reported as group
Quality
58.61
Promoting interoperability
92
Improvement activities
40
Cost
73.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
179786TNMDRegistered Nurse
18287TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blount Memorial Physician Group, Inc CurrentSince Jan 28, 2019 Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients
Summit Medical Group,PLLC Past Accepting new patients

Locations

103 W Broadway Ave
Maryville, TN 37801

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

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: khatfield864524@direct.ghs.myhfn.org
  • Direct secure messaging: krystel.hatfield.p1@direct.bmpg.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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1790108975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W BROADWAY AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014703",
            "telephone_number": "865-273-1752",
            "fax_number": "865-273-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045015",
            "telephone_number": "865-980-5100",
            "fax_number": "865-980-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATFIELD",
        "first_name": "KRYSTEL",
        "middle_name": "D",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-24",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18287",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "179786",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q005447",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.