Individual provider Active NPI

Katelin Gowder Hollingsworth, FNP-C

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1891151767
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN20498 Issued in TN
Practice address
280 Fort Sanders West Blvd Ste 101
Knoxville, TN 37922-3352
Phone
(865) 539-0270
Fax
(865) 539-6998
NPI assigned
Jan 7, 2016
Sex
Female
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN20498 TN Primary

Addresses

Primary practice location

280 Fort Sanders West Blvd Ste 101
Knoxville, TN 37922-3352

Mailing address

1275 Dick Lonas Rd
Unit 101
Knoxville, TN 37909-1383
Phone (865) 584-4747

Other identifiers 1

IdentifierTypeStateIssuer
Q046505MedicaidTN

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
I20200410001138 TN Practitioner - Nurse Practitioner 2668776584 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20498TNMDPain Medicine (Anesthesiology) Physician
APN20498TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, PLLC CurrentSince Apr 1, 2020 Accepting new patients
Summit Medical Group,PLLC CurrentSince Apr 1, 2020 Accepting new patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients
Summit Medical Group,PLLC Past Accepting new patients

Locations

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

1275 Dick Lonas Rd
Unit 101
Knoxville, TN 37909

280 Fort Sanders West Blvd
Ste 101
Knoxville, TN 37922
Phone (865) 539-0270

Organizations & group practices 4

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": "1452124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1891151767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 DICK LONAS RD",
            "address_2": "UNIT 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091383",
            "telephone_number": "865-584-4747",
            "fax_number": "865-584-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 FORT SANDERS WEST BLVD STE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223352",
            "telephone_number": "865-539-0270",
            "fax_number": "865-539-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLINGSWORTH",
        "first_name": "KATELIN",
        "middle_name": "GOWDER",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-07",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN20498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q046505",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.