Individual provider Active NPI

Nan M. Gaylord, PHD, RN, CPNP

  • Registered Nurse
  • Knoxville, TN
National Provider Identifier
1013911007
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN0000044603 Issued in TN
Practice address
220 Langland St
Knoxville, TN 37915-1415
Phone
(865) 594-5078
Fax
(865) 594-3921
NPI assigned
Jun 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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 RN0000044603 TN Primary
Pediatric Nurse Practitioner 363LP0200X APN0000005409 TN

Addresses

Primary practice location

220 Langland St
Knoxville, TN 37915-1415

Mailing address

1200 Volunteer Blvd
Utcon #335
Knoxville, TN 37996-4180
Phone (865) 974-7622

Other identifiers 1

IdentifierTypeStateIssuer
3497038MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner, Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN0000044603TNMDRegistered Nurse
APN0000005409TNMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: clinical@vineshc.directbygreenway.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312329600000",
    "number": "1013911007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 VOLUNTEER BLVD",
            "address_2": "UTCON #335",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379964180",
            "telephone_number": "865-974-7622",
            "fax_number": "865-974-3569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 LANGLAND ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379151415",
            "telephone_number": "865-594-5078",
            "fax_number": "865-594-3921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYLORD",
        "first_name": "NAN",
        "middle_name": "M.",
        "credential": "PHD, RN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-08",
        "last_updated": "2011-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN0000044603",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "APN0000005409",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3497038",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.