Individual provider Active NPI

Christopher Majer Wattenbarger

  • Physician Assistant
  • Crossville, TN
National Provider Identifier
1982416145
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
118 Brown Ave Ste 103
Crossville, TN 38555-7740
Phone
(931) 484-8861
NPI assigned
Jan 24, 2025
Last updated
Mar 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

118 Brown Ave Ste 103
Crossville, TN 38555-7740

Mailing address

118 Brown Ave Ste 103
Crossville, TN 38555-7740

Other identifiers 1

IdentifierTypeStateIssuer
Q100497MedicaidTN

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
I20250313002394 TN Practitioner - Physician Assistant 4183146608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians
Shea Physical Therapy Specialists LLCGroup PAC ID 6204245194, 194 clinicians

Practice addresses (Care Compare)

111 Clyde St
Loudon, TN 37774-1600
Phone (865) 458-1554

118 Brown Ave
Suite 103
Crossville, TN 38555-7740
Phone (931) 484-8861

5440 Everhart Rd
Suite 1
Corpus Christi, TX 78411-4838
Phone (361) 994-5224

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6379TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. Physician Assistant CurrentSince Mar 24, 2025 Accepting new patients

Locations

118 Brown Ave
Ste 103
Crossville, TN 38555
Phone (931) 484-8861

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1737676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1982416145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 BROWN AVE STE 103",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385557740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 BROWN AVE STE 103",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385557740",
            "telephone_number": "931-484-8861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTENBARGER",
        "first_name": "CHRISTOPHER",
        "middle_name": "MAJER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-24",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q100497",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

Verify at the official NPI Registry.