Sallie H Lively, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

16259 Issued in TN

Practice address

117 W Sevier Ave
Suite 100
Kingsport, TN 37660-3799

Phone

(423) 224-3300

Fax

(423) 378-5324

NPI assigned

Dec 27, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, TN2 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 2

Specialty

Nurse Practitioner

Education

East Tennessee State University Quillen College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
• Russell County Hospital Hospital, Lebanon, VA, CCN 490002
• Johnston Memorial Hospital Hospital, Abingdon, VA, CCN 490053
• Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Wellmont Medical Associates Inc

  • Family Medicine Physician
  • Big Stone Gap, VA
  • NPI 1174808216
  Medicare reassignment Care Compare group NPD
• Wellmont Medical Associates Inc

  • Pulmonary Disease Physician
  • Kingsport, TN
  • NPI 1780986257
  Medicare reassignment NPD
• Wellmont Medical Associates, Inc.

  • Psychiatry Physician
  • Johnson City, TN
  • NPI 1275393522
  NPD
• Blue Ridge Medical Management Corporation

  • Cardiovascular Disease Physician
  • Johnson City, TN
  • NPI 1740227131

  Family

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1023434339
  Care Compare affiliation
• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1962915652
  Care Compare affiliation
• Mountain States Health Alliance

  • General Acute Care Hospital
  • Johnson City, TN
  • NPI 1972606465
  Care Compare affiliation
• Wellmont Health System

  • General Acute Care Hospital
  • Bristol, TN
  • NPI 1124058615
  Care Compare affiliation
• Johnston Memorial Hospital, Inc

  • General Acute Care Hospital
  • Abingdon, VA
  • NPI 1104812684
  Care Compare affiliation
• Mountain States Health Alliance

  • General Acute Care Hospital
  • Lebanon, VA
  • NPI 1891973939
  Care Compare affiliation

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1063781714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W STONE DR",
            "address_2": "SUITE 6A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-408-7220",
            "fax_number": "423-408-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W SEVIER AVE",
            "address_2": "SUITE 100",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603799",
            "telephone_number": "423-224-3300",
            "fax_number": "423-378-5324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVELY",
        "first_name": "SALLIE",
        "middle_name": "H",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-27",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024169711",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "16259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie R Linkous, PMHNP
• April Little
• Harold Christopher Little, PA
• Jim R Littlejohn, MD
• Curtis Litton, SLP
• Savannah Nicole Livesay
• Amanda M Lizzio, OTR/L
• Gerald F London, MD FACP
• Megan Long, FNP-C
• Michael August Long, M.D.

• Family Nurse Practitioner in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.