Kaitlyn Berogan
Individual provider Active NPI Acute Care Nurse Practitioner · Knoxville, TN
NPI 1972377943 · NPPES record last updated Feb 20, 2025
Key facts
- NPI
- 1972377943
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 34791 (TN)
- Practice address
- 10608 Flickenger LN
Knoxville, TN 37922-3485 - Phone
- (833) 633-1576
- Fax
- (866) 308-4392
- NPI assigned
- Nov 10, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
10608 Flickenger LN
Knoxville, TN 37922-3251
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250916001539 | TN | Practitioner - Nurse Practitioner | 0244734044 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Gerontology Nurse Practitioner | 363LG0600X | 34791 | TN | |
| Acute Care Nurse Practitioner | 363LA2100X | 34791 | TN | Yes |
Addresses
Primary practice location
10608 Flickenger LN
Knoxville, TN 37922-3485
Mailing address
1628 El Prado Dr
Knoxville, TN 37922-5718
Other providers in Knoxville, TN
- Larry Wayne Bernard
- Michael P Bernard
- Caitlin Berndt
- Candace Berne
- Jacob R Bernier
- Angel Luis Berrios III
- Kimberly A Berry-Lavoie
- Amanda Wilson Berry
- Davis Pappandreou Berry
- James T Berry
All providers in Knoxville, TN · Acute Care Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.