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DR. KENNETH LEE JUSTICE MD
NPI 1891747853
Family Medicine in Sevierville, TN

Active since May 17, 2006PECOS EnrolledAccepts Medicare Assignment
95.69/100
CMS Quality Rating
1130 MIDDLE CREEK RD STE 260, SEVIERVILLE, TN 37862(865) 428-7586(865) 428-8671 Get Directions Write a Review

NPPES record last updated: October 30, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Kenneth Lee Justice Md NPPES

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

DR. KENNETH LEE JUSTICE MD (NPI 1891747853) is an individual family medicine provider in Sevierville, Tennessee, licensed in Tennessee (30763) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with University Health System, Inc, and is a graduate of Other (1993).

NPPES Registry Identity

NPI1891747853
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. KENNETH LEE JUSTICECredential: MD
Location Address1130 MIDDLE CREEK RD STE 260Sevierville, TN 37862-3055
Mailing AddressPo Box 440061Nashville, TN 37244-0061 · (865) 670-6199 · Fax (865) 670-6198
Phone(865) 428-7586
Fax(865) 428-8671
Sole ProprietorNo
Medical School CMSOtherGraduated 1993
Enumeration DateMay 17, 2006
Last NPPES UpdateOctober 30, 2023
NPPES CertifiedOctober 30, 2023
✔ NPI 1891747853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in TN · 30763✔ Licensed in TN · MD0000030763
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1130 MIDDLE CREEK RD STE 260, Sevierville, TN 37862
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Other Identifiers 2

Medicaid3831218TN
Medicaid3831219TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kenneth Lee Justice 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 ID7416938030
PECOS Enrollment IDI20040614001283
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.

Areas of Expertise CMS Part B claims 3

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.

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.
376 services124 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
90 services90 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
59 services43 patients

Hospital Affiliations CMS Care Compare 2

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

University Health System, Inc

Acute Care Hospitals · Knoxville, TN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440015
Location1924 Alcoa HighwayKnoxville, TN 37920 · Knox County
Emergency services Birthing friendly

Leconte Medical Center

Acute Care Hospitals · Sevierville, TN
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number440081
Location742 Middlecreek RoadSevierville, TN 37862 · Sevier County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37862 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.69/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.28
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 4

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
4 suppliers13 claims59 services$6.05 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers32 claims32 services$108.30 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier24 claims24 services$35.00 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier12 claims12 services$215.65 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 3

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

JAMIE MENDEZ LEONARD P.A.-C
Physician Assistant
1130 MIDDLE CREEK RD STE 260
SEVIERVILLE, TN 37862
Sevier County (865) 428-7586
UHS PRIMARY CARE LLC
Family Medicine
1130 MIDDLE CREEK RD STE 260
SEVIERVILLE, TN 37862
Sevier County (865) 428-7586
AMY ROSE ROBERTSON FNP-BC
Nurse Practitioner (Family)
1130 MIDDLE CREEK RD STE 260
SEVIERVILLE, TN 37862
Sevier County (865) 428-7586

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 Kenneth Justice's NPI number?

The NPI number for Kenneth Justice is 1891747853. It was assigned to this individual provider in the NPPES registry on May 17, 2006.

Where is Kenneth Justice located?

Kenneth Justice practices at 1130 Middle Creek Rd Ste 260, Sevierville, TN 37862. The listed phone number is (865) 428-7586.

What is Kenneth Justice's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kenneth Justice enrolled in Medicare?

Yes. Kenneth Justice is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kenneth Justice accept?

Health plans from BlueCross BlueShield of Tennessee and UnitedHealthcare list Kenneth Justice as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kenneth Justice affiliated with any hospitals?

According to CMS data, Kenneth Justice is affiliated with University Health System, Inc and Leconte Medical Center.

When was this NPI record last updated?

The NPPES record for Kenneth Justice was last updated on October 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.