Active NPI
Christopher Michael Kulisek, M.D.
- Gastroenterology Physician
- Lenoir City, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- MD50167
- 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
- Last updated
- Jan 24, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 43568 | KY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Gastroenterology Physician | 207RG0100X | MD50167 | TN | Primary |
Addresses
Primary practice location
576 Fort Loudoun Medical Center Dr Ste 200
Lenoir City, TN 37772-5676
Mailing address
10810 Parkside Dr
Suite G-15
Knoxville, TN 37934-1979
Phone (865) 218-7444
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kulisek.christopher.michael@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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- 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
Practice addresses (Care Compare)
Fort Loudoun Medical Ctr Dr
Suite 200
Lenoir City, TN 37772
Phone (865) 271-6180
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 127 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 168 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Medical Group, Inc. | Internal Medicine | Current | Accepting new patients |
| Covenant Medical Group, Inc | Current | Accepting new patients |
Locations
Dept 888179
Knoxville, TN 37995
550 Fort Loudon Medical Center Dr
Ste 200
Lenoir City, TN 37772
576 Fort Loudon Medical Center Dr
Ste 200
Lenoir City, TN 37772
Phone (865) 271-6180
111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554
Interoperability endpoints
- kulisek.christopher.michael@covenanthealth.cernerdirect.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Knoxville, TN
- NPI 1457302010
Internal Medicine
-
- Durable Medical Equipment & Medical Supplies
- Knoxville, TN
- NPI 1871269415
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lenoir City, TN
- NPI 1609860659
-
- General Acute Care Hospital
- Knoxville, TN
- NPI 1942294814
-
dba Peninsula Div Parkwest MC
- General Acute Care Hospital
- Knoxville, TN
- NPI 1396739165
NPI Registry JSON
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": [],
"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": []
}
Other providers in Lenoir City, TN
Sources for this page
- 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.