NPIMap

Individual provider Active NPI

Mary Beth Byrd, FNP

  • Family Nurse Practitioner
  • Erwin, TN
National Provider Identifier
1013387349
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20178 Issued in TN
Practice address
108 Gay St
Erwin, TN 37650-1228
Phone
(423) 388-4525
Fax
(423) 388-4524
NPI assigned
Sep 29, 2015
Last updated
Nov 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 175773 TN
Family Nurse Practitioner 363LF0000X 20178 TN Primary

Addresses

Primary practice location

108 Gay St
Erwin, TN 37650-1228

Mailing address

931 Prince Ave
Erwin, TN 37650-1445
Phone (423) 335-3077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151214001806 TN Practitioner - Nurse Practitioner 7315248473 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1009 N Locust Ave
Lawrenceburg, TN 38464-2746
Phone (571) 982-6636

105 Gay St
Erwin, TN 37650-1227
Phone (423) 743-6141

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
175773TNMDRegistered Nurse
20178TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Tennessee LLC CurrentSince Sep 16, 2024 Accepting new patients
Privia Medical Group Tennessee LLC CurrentSince Sep 16, 2024 Accepting new patients
Urgent Care of Erwin, LLC CurrentSince Mar 1, 2022 Accepting new patients
Shape Shifters Weight Loss and Joint Center Current Accepting new patients
Unicoi Medical Associates Past Accepting new patients

Locations

105 Gay St
Erwin, TN 37650
Phone (423) 279-1400

800 S Mohawk Dr
Ste E
Erwin, TN 37650
Phone (423) 330-6177

104 University Pkwy
Ste 1
Johnson City, TN 37604
Phone (423) 262-8300

4100 N Roan St
Ste 3
Johnson City, TN 37601
Phone (423) 268-2606

1009 N Locust Ave
Lawrenceburg, TN 38464
Phone (931) 244-7181

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23099/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/25094/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/4824/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mary.byrd.1@25094.direct.athenahealth.com

Organizations & group practices 6

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 5

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": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1013387349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 PRINCE AVE",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376501445",
            "telephone_number": "423-335-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 GAY ST",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376501228",
            "telephone_number": "423-388-4525",
            "fax_number": "423-388-4524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRD",
        "first_name": "MARY",
        "middle_name": "BETH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-29",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "175773",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "20178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erwin, TN

Sources for this page

Verify at the official NPI Registry.