Christopher Michael Kulisek, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MD50167 Issued in TN

Practice address

576 Fort Loudoun Medical Center Dr Ste 200
Lenoir City, TN 37772-5676

Phone

(865) 271-6180

Fax

(865) 374-2204

NPI assigned

Sep 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Gastroenterology

Education

East Tennessee State University Quillen College of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fort Loudoun Medical Center Hospital, Lenoir City, TN, CCN 440110
• Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125
• Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1871269415
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fort Loudoun Medical Center

  • General Acute Care Hospital
  • Lenoir City, TN
  • NPI 1609860659
  Care Compare affiliation
• Fort Sanders Regional Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1942294814
  Care Compare affiliation
• Parkwest Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1396739165
  Care Compare affiliation

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1902093537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 PARKSIDE DR",
            "address_2": "SUITE G-15",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379341979",
            "telephone_number": "865-218-7444",
            "fax_number": "865-218-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 FORT LOUDOUN MEDICAL CENTER DR STE 200",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377725676",
            "telephone_number": "865-271-6180",
            "fax_number": "865-374-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULISEK",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-27",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "43568",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "MD50167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1532357",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kulisek.christopher.michael@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "576 Fort Loudoun Medical Center Dr Ste 200",
            "city": "Lenoir City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377725676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachel Klenzman, RDN
• Nicholas Paul Klokochar, M.D.
• Knoxville Heart Center PC
• Anna Margaret Krempasky
• Kami Alyse Krinsavage, CCMA
• Daniel Dean Kyle, PHARMD
• Miriam Lagunas, BSSW
• Lakeway Pharmacy
• Nicole Rebecca Lamb, OD
• Jessica L Lambert, OTR/L

• Gastroenterology Physician in Lenoir City, TN
• Providers in Lenoir City, TN by specialty
• Gastroenterology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.