JUSTIN C KENNON MD
NPI 1104265099
Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery in Knoxville, TN

Q: What is Justin Kennon's NPI number?

The NPI number for Justin Kennon is 1104265099. It was assigned to this individual provider in the NPPES registry on June 24, 2013.

Q: What is Justin Kennon's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Adult Reconstructive Orthopaedic Surgery, with taxonomy code 207XS0114X.

Q: When was this NPI record last updated?

The NPPES record for Justin Kennon was last updated on July 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 24, 2013PECOS EnrolledAccepts Medicare Assignment

9430 PARK WEST BLVD STE 130, KNOXVILLE, TN 37923(865) 690-4861(865) 560-8525 Get Directions Write a Review

NPPES record last updated: July 11, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 11, 2025, Oct 13, 2023, Oct 27, 2022 and 4 more (7 updates tracked since 2018).

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About Justin C Kennon Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUSTIN C KENNON MD (NPI 1104265099) is an individual adult reconstructive orthopaedic surgery provider in Knoxville, Tennessee, licensed in Tennessee (58814) and active in the NPI registry since June 2013. He is enrolled in Medicare PECOS, is affiliated with Roane Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1104265099

Entity TypeIndividualMale

Primary Taxonomy207XS0114X

Provider Legal NameJUSTIN C KENNONCredential: MD

Location Address9430 PARK WEST BLVD STE 130Knoxville, TN 37923-4205

Mailing AddressPo Box 306556Nashville, TN 37230-6556 · (865) 694-0062 · Fax (865) 694-7907

Phone(865) 690-4861

Fax(865) 560-8525

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateJune 24, 2013

Last NPPES UpdateJuly 11, 20257 updates tracked since enumeration

NPPES CertifiedJuly 11, 2025

✔ NPI 1104265099 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Adult Reconstructive Orthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207XS0114X

License✔ Licensed in TN · 58814

Definition

Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures.

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License 58814 (TN)

9430 PARK WEST BLVD STE 130, Knoxville, TN 37923

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Secondary Practice Locations 2

Location 16484 Kingston PikeKnoxville, TN 37919-4863 · Phone (865) 690-4861 · Fax (865) 693-0338

Location 2988 Oak Ridge Tpke Ste 100Oak Ridge, TN 37830-6919 · Phone (865) 483-8478 · Fax (865) 483-4194

Other Identifiers 1

MedicaidQ047643TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, Cigna Healthcare, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Justin C Kennon Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6709028855

PECOS Enrollment IDI20190905001630

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Justin Kennon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Tennessee Orthopaedic Alliance PA

Same address

Magnetic Resonance Imaging

9430 PARK WEST BLVD STE 235
Knoxville, TN 37923

Reassigned Medicare billing, Tennessee enrollment
365 clinicians in this Medicare group

NPI 1124614581 (865) 690-4861

Tennessee Orthopaedic Clinics PC

Same address

Physical Therapy

9430 PARK WEST BLVD, SUITE 230
Knoxville, TN 37923

Reassigned Medicare billing, Tennessee enrollment
50 clinicians in this Medicare group

NPI 1427464114 (865) 560-8550

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 15

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

884 services104 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

443 services274 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

308 services238 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

214 services177 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

118 services102 patients

Prosthetic repair of shoulder joint, total shoulder 23472

Total shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.

67 services65 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

60 services60 patients

Repair of shoulder rotator cuff using an endoscope 29827

This procedure, known as arthroscopic rotator cuff repair, helps fix tears in the shoulder's rotator cuff. An endoscope, a small camera, is used to view the shoulder inside. Using small tools, the surgeon repairs the torn tissue. This minimally invasive approach often leads to a quicker recovery.

36 services36 patients

Shaving of part of shoulder bone and repair of ligament using an endoscope 29826

This procedure involves using a tiny camera, called an endoscope, to view and repair a damaged shoulder ligament. Simultaneously, a small portion of the shoulder bone is shaved to alleviate discomfort and improve movement. It's a minimally invasive technique that aids in a quicker recovery.

29 services29 patients

Release of tendon connecting biceps muscle and shoulder using an endoscope 29828

This procedure involves using a small camera, known as an endoscope, to view and release the tendon connecting your biceps muscle and shoulder. It can help reduce pain and improve mobility. The procedure is minimally invasive, promoting quicker recovery.

27 services27 patients

Mri scan of leg joint without contrast 73721

An MRI scan of your leg joint is a non-invasive procedure that uses magnetic fields and radio waves to create detailed images of the structures within your leg. This helps doctors diagnose or monitor conditions without using contrast dye.

23 services22 patients

X-ray of elbow, minimum of 3 views 73080

An elbow X-ray with a minimum of 3 views is a non-invasive imaging test. It helps visualize the bones of the elbow from different angles. This aids in diagnosing conditions like fractures or arthritis. The procedure is quick, painless, and usually takes around 15 minutes.

22 services19 patients

Partial removal of collar bone at shoulder using an endoscope 29824

This procedure involves the partial removal of the collar bone at the shoulder using an endoscope, a tool with a light and camera. It's done to relieve pain or improve shoulder movement. The surgeon makes small incisions, then uses the endoscope to guide their work.

21 services21 patients

Mri scan of arm joint without contrast 73221

An MRI scan of the arm joint is a non-invasive imaging procedure that uses magnetic fields and radio waves to create detailed images of the structures within your arm joint. No contrast dye is used in this process. It helps to diagnose or monitor conditions like arthritis, injuries, or infections.

16 services15 patients

Mri scan of lower spinal canal without contrast 72148

An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.

14 services14 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Roane Medical Center

Acute Care Hospitals · Harriman, TN

5/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number440031

Location8045 Roane Medical Center DriveHarriman, TN 37748 · Roane County

Emergency services

Methodist Medical Center Of Oak Ridge

Acute Care Hospitals · Oak Ridge, TN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440034

Location990 Oak Ridge Turnpike Box 529Oak Ridge, TN 37830 · Anderson County

Emergency services Birthing friendly

Fort Loudoun Medical Center

Acute Care Hospitals · Lenoir City, TN

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number440110

Location550 Fort Loudon Medical Center DrLenoir City, TN 37772 · Loudon County

Emergency services

Fort Sanders Regional Medical Center

Acute Care Hospitals · Knoxville, TN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440125

Location1901 W Clinch AveKnoxville, TN 37916 · Knox County

Emergency services Birthing friendly

Parkwest Medical Center

Acute Care Hospitals · Knoxville, TN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440173

Location9352 Park West BlvdKnoxville, TN 37923 · Knox County

Emergency services Birthing friendly

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Neuromuscular stimulator, electronic shock unit E0745

DME-Other DME · category DE000N

1 supplier11 claims11 services$44.25 avg. paid by Medicare

Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf L3670

DME-Orthotic Devices · category DF000N

3 suppliers13 claims13 services$109.60 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MICHAEL C. TOMPKINS DO

Orthopaedic Surgery