KNOXVILLE MEDICAL GROUP, LLC
NPI 1235641796
Nurse Practitioner - Family in Knoxville, TN

Q: What is Knoxville Medical Group, LLC's NPI number?

The NPI number for Knoxville Medical Group, LLC is 1235641796. It was assigned to this organization in the NPPES registry on October 24, 2017.

Q: What is Knoxville Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since October 24, 2017CLIA 44D2141265 · Waiver

7523 MAYNARDVILLE PIKE, KNOXVILLE, TN 37938(865) 630-4302 Get Directions Write a Review

NPPES record last updated: April 20, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 20, 2022, Nov 1, 2018, Jun 16, 2018 and 1 more (4 updates tracked since 2017).

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About Knoxville Medical Group, Llc NPPES

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

KNOXVILLE MEDICAL GROUP, LLC (NPI 1235641796) is a healthcare organization registered as a family in Knoxville, Tennessee and active in the NPI registry since October 2017. The organization holds a CLIA Waiver certificate valid through December 10, 2027, maintains a secondary practice location in Knoxville, and lists Amber D Roberts, Billing/credentialing, as its authorized official.

NPPES Registry Identity

NPI1235641796

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameKNOXVILLE MEDICAL GROUP, LLC

Location Address7523 MAYNARDVILLE PIKEKnoxville, TN 37938-3722

Mailing Address7523 Maynardville PikeKnoxville, TN 37938 · (865) 630-4302 · Fax (865) 630-4303

Phone(865) 630-4302

Organization SubpartNo

Authorized OfficialAmber D RobertsBilling/credentialing · (423) 736-3649

Enumeration DateOctober 24, 2017

Last NPPES UpdateApril 20, 20224 updates tracked since enumeration

NPPES CertifiedApril 6, 2022

✔ NPI 1235641796 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in TN · 21594

7523 MAYNARDVILLE PIKE, Knoxville, TN 37938

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Secondary Practice Location 1

Location 1117 Legacy View Way Ste 117Knoxville, TN 37918-8230 · Phone (865) 630-4302 · Fax (865) 630-4303

Other Identifiers 2

Other21594TN · State License

Other1053764761TN · Npi

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D2141265

Knoxville Medical Group, LLC · Knoxville, TN

Active · expires Dec 10, 2027

CLIA Number44D2141265

Laboratory TypePractitioner Other

Certificate Effective DateDecember 11, 2025

Certificate Expiration DateDecember 10, 2027

Laboratory DirectorMary F. Sadiku

Laboratory Phone(865) 630-4302

Laboratory LocationKnoxville Medical Group, LLC7523 Maynardville Pike, Knoxville, TN 37938

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

MARY FAITH SADIKU

Nurse Practitioner (Family)

7523 MAYNARDVILLE PIKE
KNOXVILLE, TN 37938

Knox County (865) 630-4302

TIFFANY LONG-HILL

Nurse Practitioner (Family)

7523 MAYNARDVILLE PIKE
KNOXVILLE, TN 37938

Knox County (865) 630-4302

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Knoxville Medical Group, LLC's NPI number?

The NPI number for Knoxville Medical Group, LLC is 1235641796. It was assigned to this organization in the NPPES registry on October 24, 2017.

Where is Knoxville Medical Group, LLC located?

Knoxville Medical Group, LLC is located at 7523 Maynardville Pike, Knoxville, TN 37938. The listed phone number is (865) 630-4302.

What is Knoxville Medical Group, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Knoxville Medical Group, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2141265) is associated with this NPI, valid through December 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Knoxville Medical Group, LLC was last updated on April 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.