Individual provider Active NPI

Alexis Hodge Duty, FNP

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1063823185
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000018585 Issued in TN
Practice address
408 N State of Franklin Rd
Suite 31B
Johnson City, TN 37604-6089
Phone
(423) 431-4946
Fax
(423) 431-4947
NPI assigned
May 12, 2014
Last updated
Feb 1, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN0000018585 TN Primary

Addresses

Primary practice location

408 N State of Franklin Rd
Suite 31B
Johnson City, TN 37604-6089

Mailing address

408 N State of Franklin Rd
Suite 31B
Johnson City, TN 37604-6089
Phone (423) 431-4946

Other identifiers 1

IdentifierTypeStateIssuer
1533969MedicaidTN

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
I20151208000320 TN Practitioner - Nurse Practitioner 2860792207 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN0000018585TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Sep 8, 2015 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Sep 8, 2015 Accepting new patients

Locations

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

2 Professional Park Dr
Ste 15
Johnson City, TN 37604
Phone (423) 232-4867

408 N State of Franklin Rd
Ste 31B
Johnson City, TN 37604
Phone (423) 431-4946

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": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1063823185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 N STATE OF FRANKLIN RD",
            "address_2": "SUITE 31B",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046089",
            "telephone_number": "423-431-4946",
            "fax_number": "423-431-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N STATE OF FRANKLIN RD",
            "address_2": "SUITE 31B",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046089",
            "telephone_number": "423-431-4946",
            "fax_number": "423-431-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTY",
        "first_name": "ALEXIS",
        "middle_name": "HODGE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000018585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1533969",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.