Mary Lou Cameron Fornehed, ACNP, BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

6081 Issued in TN

Practice address

145 W 4TH St Ste 201
Cookeville, TN 38501

Phone

(931) 783-2143

Fax

(931) 783-2152

NPI assigned

Jul 9, 2006

Last updated

Jul 13, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Merit-based Incentive Payment System (MIPS)

Final score

40.99 of 100Reported as group

Quality

58.34

Promoting interoperability

0

Improvement activities

0

Cost

78.29

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10383/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/8546/brand/1/csg/1/fhir/r4

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.

• Cookeville Regional Medical Group, Inc

  • Multi-Specialty Clinic/Center
  • Cookeville, TN
  • NPI 1649202102
  Medicare reassignment NPD
• TN Lung and Sleep Center LLC

  • Pulmonary Disease Physician
  • Cookeville, TN
  • NPI 1265057855
  Medicare reassignment NPD
• American Anesthesiology Consultants PLLC

  • Specialist
  • Cookeville, TN
  • NPI 1700044278
  NPD (past)
• Reliable Healthcare, PLLC

  • Primary Care Clinic/Center
  • Cookeville, TN
  • NPI 1497170146
  NPD (past)

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1083647275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W 7TH ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011726",
            "telephone_number": "931-783-5582",
            "fax_number": "931-526-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 W 4TH ST STE 201",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "38501",
            "telephone_number": "931-783-2143",
            "fax_number": "931-783-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNEHED",
        "first_name": "MARY LOU",
        "middle_name": "CAMERON",
        "name_prefix": "Mrs.",
        "credential": "ACNP, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "6081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4346448",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1530878",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "4026322",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78013588",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia J Folyer, FNP-BC, APN
• Foods of the Spirit, LLC
• Steven T Ford, BS
• Charlotte Forkum
• John W Fornabaio Jr., P.T.
• Rachel L Forsythe, MSN, ACNP-BC
• Kayla Marie Foster, DNP
• Ronda Foster
• Timothy Scott Fournet, M.D.
• Wendy Holland Foust, FNP-C

• Acute Care Nurse Practitioner in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Acute Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.