Chelsea Lane Gondek
Individual provider Active NPI Family Nurse Practitioner · East Ridge, TN
NPI 1013474352 · NPPES record last updated Mar 26, 2019
Key facts
- NPI
- 1013474352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F01191764 (TN)
- Practice address
- 961 Spring Creek Rd Ste 300
East Ridge, TN 37412 - Phone
- (423) 839-9787
- NPI assigned
- Feb 22, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Twelvestone Infusion Centers LLC
Practice addresses (Care Compare)
352 W Northfield Blvd
Suite 4C
Murfreesboro, TN 37129-1539
Phone (844) 893-0012
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190719001717 | TN | Practitioner - Nurse Practitioner | 7012243652 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F01191764 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crossroads Medical Group, PLLC | Current |
Accepting new patients | |
| Twelvestone Infusion Centers LLC | Current |
Accepting new patients |
Locations
352 W Northfield Blvd
Ste 4C
Murfreesboro, TN 37129
Phone (615) 895-6977
3443 Dickerson Pike
Ste 380
Nashville, TN 37207
Phone (615) 860-2221
491 Sage Rd N
Ste 200
White House, TN 37188
Phone (615) 581-5925
Interoperability endpoints
- chelsea.gondek@hca1.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F01191764 | TN | Yes |
Addresses
Primary practice location
961 Spring Creek Rd Ste 300
East Ridge, TN 37412
Mailing address
961 Spring Creek Rd Ste 300
East Ridge, TN 37412-3976
Phone (770) 289-3244
Other practice location 1
1208 Spring Creek Rd
East Ridge, TN 37412-3916
Phone (770) 289-3244
Other providers in East Ridge, TN
- Frazier Transportation LLC
- John Mark Frazier
- Yulonda Mashell Garth
- Gentle Care Supportive Services LLC
- Cameron Gilfillan
- Ashley D Guthrie
- Cody Sean Hall
- Sherry McClendon Hankins
- Healing Waters Counseling, LLC
- Randy Robert Heisser
All providers in East Ridge, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.