King'S Way Family Medicine, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

KING'S WAY FAMILY MEDICINE, LLC

Practice address

318 Tusculum Blvd
Greeneville, TN 37745-3926

Phone

(423) 639-7700

Fax

(423) 639-7700

NPI assigned

Jan 25, 2019

Organization subpart

No

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

Authorized official

Name

Ms. Heather Olson, NURSE PRACTITIONERNPI 1215233812

Title

Owner/Provider

Phone

(386) 801-3083

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heather Olson, ARNP

  • Family Nurse Practitioner
  • Greeneville, TN
  • NPI 1215233812
  Medicare reassignment Authorized official
• Deanna Williamson, FNP-C

  • Family Nurse Practitioner
  • Limestone, TN
  • NPI 1255142113
  Medicare reassignment NPD
• Jaime Lee McClellan, APRN

  • Family Nurse Practitioner
  • Maryville, TN
  • NPI 1770113136
  Medicare reassignment
• Michelle Lee Hale, FNP-BC

  • Family Nurse Practitioner
  • Greeneville, TN
  • NPI 1740654714
  NPD

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

{
    "created_epoch": "1548374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548806400000",
    "number": "1083178974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 TUSCULUM BLVD",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377453926",
            "telephone_number": "386-837-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 TUSCULUM BLVD",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377453926",
            "telephone_number": "423-639-7700",
            "fax_number": "423-639-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING'S WAY FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-25",
        "last_updated": "2019-01-30",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "386-801-3083",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa M Kidd, PHD
• Kidsfirst Pediatrics, Inc.
• Helen Christine Kilday, LCSW BSW MSSW
• Leah Nicole Kimerer, DMD
• King Springs
• Lisa J. Kinser, LPN
• Ryan Randell Kite, MA
• Victoria Lynn Kite, OTR
• David Knecht, DC
• Aaron C Knop, D.M.D

• Primary Care Clinic/Center in Greeneville, TN
• Providers in Greeneville, TN by specialty
• Primary Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.