Individual provider Active NPI

Marta Kuniec, NP

  • Pediatric Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1891141610
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
21194 Issued in TN
Practice address
10857 Hardin Valley Rd
Knoxville, TN 37932-1410
Phone
(865) 690-2682
Fax
(866) 529-5509
NPI assigned
May 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 21194 TN Primary

Addresses

Primary practice location

10857 Hardin Valley Rd
Knoxville, TN 37932-1410

Mailing address

PO Box 15004
Knoxville, TN 37901-5004
Phone (865) 541-8895

Other practice location 1

224 S Peters Rd Ste 105
Knoxville, TN 37923-5207
Phone (865) 470-8844

Other identifiers 1

IdentifierTypeStateIssuer
Q022377MedicaidTN

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
21194TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Children's Primary Care Center, Inc. Pediatrics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1891141610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15004",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379015004",
            "telephone_number": "865-541-8895",
            "fax_number": "865-633-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10857 HARDIN VALLEY RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321410",
            "telephone_number": "865-690-2682",
            "fax_number": "866-529-5509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 S Peters Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379235207",
            "country_code": "US",
            "telephone_number": "865-470-8844",
            "fax_number": "866-479-4403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUNIEC",
        "first_name": "MARTA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "21194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q022377",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "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 Jan 9, 2023; 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.