Anne Porcher Burnett, NP-C

Individual provider Active NPI Family Nurse Practitioner · Monteagle, TN

NPI 1053780262 · NPPES record last updated Sep 17, 2015

Key facts

NPI
1053780262
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
20423 (TN)
Practice address
21 1St Street
Mountain Medical Clinic
Monteagle, TN 37356-7401
Phone
(931) 924-8000
NPI assigned
Sep 17, 2015
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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 IDStateProvider typePAC IDDetails
I20151029001766 TN Practitioner - Nurse Practitioner 4688983877 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
20423TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amg-Southern Tennessee LLC Current
since Oct 1, 2015
Accepting new patients
Amg-Southern Tennessee LLC Current
since Oct 1, 2015
Accepting new patients

Locations

300 S Main St
Estill Springs, TN 37330
Phone (931) 649-5139

21 1st St
Monteagle, TN 37356
Phone (931) 598-5691

100 Hunters Ln
Tullahoma, TN 37388
Phone (931) 455-4616

185 Hospital Rd
Winchester, TN 37398
Phone (931) 962-4061

83 Memorial Dr
Winchester, TN 37398
Phone (931) 967-3966

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 20423 TN Yes

Addresses

Primary practice location

21 1St Street
Mountain Medical Clinic
Monteagle, TN 37356-7401

Mailing address

21 1St Street
Mountain Medical Clinic
Monteagle, TN 37356-7401
Phone (931) 924-8000

Other providers in Monteagle, TN

All providers in Monteagle, TN · Family Nurse Practitioner in Tennessee

Sources for this page

Verify at the official NPI Registry.