Individual provider Active NPI

Nicole Ann Asante, FNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Jellico, TN
National Provider Identifier
1053544890
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3017532 Issued in KY
Practice address
1811 5TH St
Jellico, TN 37762-4629
Phone
(423) 455-3032
NPI assigned
Aug 27, 2009
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 14174 TN
Nurse Practitioner 363L00000X 3017532 KY
Family Nurse Practitioner 363LF0000X APN14174 TN
Family Nurse Practitioner 363LF0000X 3017532 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3017532 KY Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11019469 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 12.013968 CT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 14174 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN14174 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61611207 WA
Primary Care Nurse Practitioner 363LP2300X 3017532 KY
Primary Care Nurse Practitioner 363LP2300X 14174 TN

Addresses

Primary practice location

1811 5TH St
Jellico, TN 37762-4629

Mailing address

1811 5TH St
Jellico, TN 37762-4629
Phone (423) 455-3032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY, WA, CT4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20091021000600 TN Practitioner - Nurse Practitioner 2961549027 Reassigns benefits to 5 organizations
Practice locations: Jellico, TN
I20220823000203 KY Practitioner - Nurse Practitioner 2961549027 Reassigns benefits to 3 organizations
I20250429003285 WA Practitioner - Nurse Practitioner 2961549027 Reassigns benefits to 1 organization
I20250724002106 CT Practitioner - Nurse Practitioner 2961549027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Volunteer Behavioral Health Care SystemGroup PAC ID 3678485802, 44 clinicians

Practice addresses (Care Compare)

4325 Hwy 127 N
Crossville, TN 38571-0587
Phone (931) 484-8020

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14174TNMDSocial Worker
APRN11019469FLMDPsychiatric/Mental Health Nurse Practitioner
APN14174TNMDPsychiatric/Mental Health Nurse Practitioner
AP61611207WAMDPsychiatric/Mental Health Nurse Practitioner
3017532KYMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Volunteer Behavioral Health Care System Single Specialty CurrentSince Aug 22, 2022 Accepting new patients
Grow Healthcare Group PA Single Specialty CurrentSince Jun 26, 2024 Accepting new patients
Sondermind, P.a. Single Specialty CurrentSince Jan 1, 2025 Accepting new patients
Brightside Medical, P.C. Single Specialty CurrentSince Oct 1, 2025 Accepting new patients
Mental Health Specialty Group PA Single Specialty CurrentSince May 1, 2025 Accepting new patients
Kentucky Counseling Center, LLC Single Specialty CurrentSince Jul 18, 2022 Accepting new patients
KCC Recovery, LLC Dba Bluegrass Recovery, LLC Nurse Practitioner Past Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

1169 Eastern Pkwy
Ste 3328
Louisville, KY 40217
Phone (205) 914-2526

312 S 4th St
Louisville, KY 40202
Phone (502) 213-5590

312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023

4835 Poplar Level Rd
Ste 110
Louisville, KY 40213
Phone (502) 424-5002

413 Spring St
Chattanooga, TN 37405
Phone (423) 756-2740

2700 Executive Park NW
Cleveland, TN 37312
Phone (423) 479-9581

4325 Highway 127 N
Crossville, TN 38571
Phone (931) 484-8020

8913 Town and Country Cir
Knoxville, TN 37923
Phone (253) 861-0739

1504 Williams Dr
Murfreesboro, TN 37129
Phone (615) 278-2241

40 Burton Hills Blvd
Ste 200
Nashville, TN 37215
Phone (615) 257-8410

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/vbhcs/r4/

Organizations & group practices 8

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 1

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": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1053544890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 5TH ST",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377624629",
            "telephone_number": "423-455-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 5TH ST",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377624629",
            "telephone_number": "423-455-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASANTE",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "14174",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3017532",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN14174",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3017532",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3017532",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11019469",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "12.013968",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "14174",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "APN14174",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61611207",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "KY",
            "license": "3017532",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "14174",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jellico, TN

Sources for this page

Verify at the official NPI Registry.