Individual provider Active NPI

Kenneth Robert Johnsen, MD

  • Rheumatology Physician
  • Knoxville, TN
National Provider Identifier
1851650865
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
51150 Issued in TN
Practice address
4707 Papermill Dr Ste 200
Knoxville, TN 37909-1907
Phone
(865) 602-7983
Fax
(865) 602-7984
NPI assigned
May 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 51150 TN
Hospitalist Physician 208M00000X 51150 TN
Rheumatology Physician 207RR0500X 51150 TN Primary

Addresses

Primary practice location

4707 Papermill Dr Ste 200
Knoxville, TN 37909-1907

Mailing address

4707 Papermill Dr Ste 200
Knoxville, TN 37909-1907
Phone (865) 602-7983

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151020000283 TN Practitioner - RheumatologyPractitioner - Internal Medicine 4284871815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Rheumatology Consultants, PLLCGroup PAC ID 1951478502, 7 clinicians

Practice addresses (Care Compare)

101 Cherokee PL
Suite 107
Loudon, TN 37774-4162
Phone (865) 408-9344

4707 Papermill Dr
Suite 200
Knoxville, TN 37909-1907
Phone (865) 602-7983

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51150TNMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rheumatology Consultants, PLLC Rheumatology CurrentSince Jul 1, 2017 Accepting new patients
Abercrombie Radiological Consultants Inc PastSince Jul 1, 2017 Accepting new patients

Locations

4707 Papermill Dr
Ste 200
Knoxville, TN 37909
Phone (865) 602-7983

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72064

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": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1851650865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4707 PAPERMILL DR STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091907",
            "telephone_number": "865-602-7983",
            "fax_number": "865-602-7984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 PAPERMILL DR STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091907",
            "telephone_number": "865-602-7983",
            "fax_number": "865-602-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSEN",
        "first_name": "KENNETH",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-10",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "51150",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "51150",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "TN",
            "license": "51150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.