Individual provider Active NPI

Laura Mathis

  • Family Nurse Practitioner
  • Sevierville, TN
National Provider Identifier
1841666583
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20024 Issued in TN
Practice address
744 Middle Creek Rd Ste 108
Sevierville, TN 37862-5036
Phone
(865) 446-9500
NPI assigned
Aug 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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 20024 TN Primary

Addresses

Primary practice location

744 Middle Creek Rd Ste 108
Sevierville, TN 37862-5036

Mailing address

744 Middle Creek Rd Ste 108
Sevierville, TN 37862-5036
Phone (865) 446-9500

Other identifiers 1

IdentifierTypeStateIssuer
Q015609MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mathis.laura.a@covenanthealth.cernerdirect.com

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
I20151103003177 TN Practitioner - Nurse Practitioner 1759691785 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Urology PCGroup PAC ID 4486677978, 15 clinicians

Practice addresses (Care Compare)

1928 Alcoa Hwy
Suite B222
Knoxville, TN 37920-1504
Phone (865) 305-9254

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20024TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Urology PC CurrentSince Jul 22, 2023 Accepting new patients
DX Mso, PLLC CurrentSince Mar 3, 2018 Accepting new patients
Northshore Urgent Care CurrentSince Jul 22, 2023 Accepting new patients

Locations

700 E 54th St N
Sioux Falls, SD 57104
Phone (423) 458-1426

1025 Peerless Xing NW
Cleveland, TN 37312
Phone (423) 476-5990

1928 Alcoa Hwy
Ste B222
Knoxville, TN 37920
Phone (865) 544-9254

2046 Town Center Blvd
Knoxville, TN 37922
Phone (865) 228-0424

Interoperability endpoints

  • Direct secure messaging: mathis.laura.a@covenanthealth.cernerdirect.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 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": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1841666583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 MIDDLE CREEK RD STE 108",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378625036",
            "telephone_number": "865-446-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 MIDDLE CREEK RD STE 108",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378625036",
            "telephone_number": "865-446-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "20024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q015609",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mathis.laura.a@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "744 Middle Creek Rd Ste 108",
            "city": "Sevierville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378625036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sevierville, TN

Sources for this page

Verify at the official NPI Registry.