Individual provider Active NPI

Kelly Nicole Robins, FNP

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1063257095
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
36735 Issued in TN
Practice address
2428 Knob Creek Rd Ste 201
Johnson City, TN 37604-2396
Phone
(423) 262-4400
NPI assigned
Jul 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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 250022 TN
Family Nurse Practitioner 363LF0000X 36735 TN Primary

Addresses

Primary practice location

2428 Knob Creek Rd Ste 201
Johnson City, TN 37604-2396

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

400 N State Of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111

Other practice location 2

115 Judge Gresham Rd Ste A
Gray, TN 37615-6213
Phone (423) 467-3000

Other practice location 3

1410 Tusculum Blvd Ste 1500
Greeneville, TN 37745-5810
Phone (423) 638-2270

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
I20241112003778 TN Practitioner - Nurse Practitioner 0143754242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Cardiology ServicesGroup PAC ID 5799970281, 137 clinicians

Practice addresses (Care Compare)

2428 Knob Creek Rd
Suite 201
Johnson City, TN 37604-2396
Phone (423) 282-5054

Hospital & facility affiliations

  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
  • Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
  • Greeneville Community Hospital Hospital, Greeneville, TN, CCN 440050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
250022TNMDRegistered Nurse
36735TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Cardiology Services Family CurrentSince Nov 1, 2024 Accepting new patients

Locations

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

115 Judge Gresham Rd
Ste A
Gray, TN 37615
Phone (423) 467-3000

1410 Tusculum Blvd
Ste 1500
Greeneville, TN 37745
Phone (423) 638-2270

2428 Knob Creek Rd
Ste 201
Johnson City, TN 37604
Phone (423) 262-4400

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

2050 Meadowview Pkwy
Kingsport, TN 37660

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1063257095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111",
            "fax_number": "423-282-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 KNOB CREEK RD STE 201",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042396",
            "telephone_number": "423-262-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046035",
            "country_code": "US",
            "telephone_number": "423-431-6111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Judge Gresham Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Gray",
            "state": "TN",
            "postal_code": "376156213",
            "country_code": "US",
            "telephone_number": "423-467-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1410 Tusculum Blvd Ste 1500",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377455810",
            "country_code": "US",
            "telephone_number": "423-638-2270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINS",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "250022",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "36735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.