Individual provider Active NPI

Kristen Wendt, PA-C

  • Physician Assistant
  • Knoxville, TN
National Provider Identifier
1831840313
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4916 Issued in TN
Practice address
4711 Centerline Dr Ste 100
Knoxville, TN 37917-1405
Phone
(865) 647-1876
Fax
(865) 471-2246
NPI assigned
Jan 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4916 TN Primary

Addresses

Primary practice location

4711 Centerline Dr Ste 100
Knoxville, TN 37917-1405

Mailing address

4711 Centerline Dr Ste 100
Knoxville, TN 37917-1405
Phone (865) 647-1876

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
I20220411000886 TN Practitioner - Physician Assistant 6305232810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knoxville Hma Physician Management, LLCGroup PAC ID 6103097316, 118 clinicians

Practice addresses (Care Compare)

10810 Parkside Dr
Knoxville, TN 37934-1981

10820 Parkside Dr
Knoxville, TN 37934-1956
Phone (865) 218-7011

7557 A Dannaher Dr
Suite G15
Powell, TN 37849-3558
Phone (865) 859-7377

Hospital & facility affiliations

  • Physicians Regional Medical Center Hospital, Powell, TN, CCN 440120
  • Tennova Healthcare-Jefferson Memorial Hospital Hospital, Jefferson City, TN, CCN 440056

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as apm
Quality
73.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4916TNMDOccupational Therapist

Interoperability endpoints

  • Direct secure messaging: kristen.wendt.1@4694.direct.athenahealth.com

Organizations & group practices 2

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.

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": "1642204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1831840313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 CENTERLINE DR STE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379171405",
            "telephone_number": "865-647-1876",
            "fax_number": "865-471-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 CENTERLINE DR STE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379171405",
            "telephone_number": "865-647-1876",
            "fax_number": "865-471-2246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDT",
        "first_name": "KRISTEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-15",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.