Active NPI
George Menees Krisle III, MD
- Cardiovascular Disease Physician
- Knoxville, TN
National Provider Identifier
1811986623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- MD0000010517
- Practice address
- 1819 W Clinch Ave
Suite 108
Knoxville, TN 37916-2435 - Phone
- (865) 546-5111
- Fax
- (865) 541-4018
- NPI assigned
- Oct 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | MD0000010517 | TN | Primary |
Addresses
Primary practice location
1819 W Clinch Ave
Suite 108
Knoxville, TN 37916-2435
Mailing address
1819 W Clinch Ave
Suite 108
Knoxville, TN 37916-2435
Phone (865) 546-5111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1512034 | Medicaid | TN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | krisle.george@covenanthealth.cernerdirect.com |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10517 | TN | MD | Pharmacist |
| MD0000010517 | TN | MD | Cardiovascular Disease Physician |
Interoperability endpoints
- krisle.george@covenanthealth.cernerdirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593388800000",
"number": "1811986623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1819 W CLINCH AVE",
"address_2": "SUITE 108",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379162435",
"telephone_number": "865-546-5111",
"fax_number": "865-541-4018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1819 W CLINCH AVE",
"address_2": "SUITE 108",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379162435",
"telephone_number": "865-546-5111",
"fax_number": "865-541-4018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRISLE",
"first_name": "GEORGE",
"middle_name": "MENEES",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-14",
"last_updated": "2020-06-29",
"certification_date": "2020-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "TN",
"license": "MD0000010517",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1512034",
"state": "TN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "krisle.george@covenanthealth.cernerdirect.com",
"affiliation": "N",
"address_1": "1819 W Clinch Ave",
"address_2": "Suite 108",
"city": "Knoxville",
"state": "TN",
"country_code": "US",
"postal_code": "379162435",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}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 Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.