Individual provider Active NPI

Kristy Renee Houghton, FNP

  • Family Nurse Practitioner
  • Bluff City, TN
National Provider Identifier
1023485190
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18887 Issued in TN
Practice address
229 Highway 19 E
Bluff City, TN 37618-1865
Phone
(423) 538-5116
Fax
(423) 538-3861
NPI assigned
Aug 25, 2015
Last updated
Aug 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024178048 VA
Family Nurse Practitioner 363LF0000X 18887 TN Primary

Addresses

Primary practice location

229 Highway 19 E
Bluff City, TN 37618-1865

Mailing address

PO Box 850
Rogersville, TN 37857-0850
Phone (423) 538-5116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151007003285 TN Practitioner - Nurse Practitioner 7719295971 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Pac Healthcare Services of Tennessee PC CurrentSince Feb 1, 2021 Accepting new patients
CS Pacs 3 Southeast, LLC CurrentSince Jul 16, 2024 Accepting new patients
NV Pacs 2 LLC CurrentSince Aug 25, 2021 Accepting new patients

Locations

880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1023485190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378570850",
            "telephone_number": "423-538-5116",
            "fax_number": "423-538-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 HIGHWAY 19 E",
            "city": "BLUFF CITY",
            "state": "TN",
            "postal_code": "376181865",
            "telephone_number": "423-538-5116",
            "fax_number": "423-538-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUGHTON",
        "first_name": "KRISTY",
        "middle_name": "RENEE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024178048",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluff City, TN

Sources for this page

Verify at the official NPI Registry.