Individual provider Active NPI

Kristen Ann Wilcut, APRN

  • Family Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1790398394
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27556 Issued in TN
Practice address
8034 E Brainerd Rd
Chattanooga, TN 37421-3205
Phone
(866) 389-2727
NPI assigned
Aug 25, 2020
Last updated
May 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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 27556 TN Primary

Addresses

Primary practice location

8034 E Brainerd Rd
Chattanooga, TN 37421-3205

Mailing address

8034 E Brainerd Rd
Chattanooga, TN 37421-3205
Phone (423) 267-5060

Other practice location 1

5120 Highway 153
Hixson, TN 37343-4520
Phone (423) 876-9396

Other names 1

  • Kristen Ann Wagner Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1790398394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8034 E BRAINERD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213205",
            "telephone_number": "423-267-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8034 E BRAINERD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213205",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5120 Highway 153",
            "address_purpose": "LOCATION",
            "city": "Hixson",
            "state": "TN",
            "postal_code": "373434520",
            "country_code": "US",
            "telephone_number": "423-876-9396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILCUT",
        "first_name": "KRISTEN",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "WAGNER",
            "middle_name": "ANN",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; 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.