Kyle Allan Hopper
Individual provider Active NPI Physician Assistant · Milligan, TN
NPI 1104677897 · NPPES record last updated Mar 29, 2024
Key facts
- NPI
- 1104677897
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 101 Neth Dr
Milligan, TN 37682-3015 - Phone
- (423) 461-8700
- NPI assigned
- Mar 29, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lake Cumberland Physician Practices LLC
Practice addresses (Care Compare)
30 Tower Cir
Somerset, KY 42503-3476
Phone (606) 451-8644
301 Langdon St
Somerset, KY 42503-2750
Phone (606) 678-9688
305 Langdon St
Somerset, KY 42503-2750
Phone (606) 676-0206
56 Tower Cir
Somerset, KY 42503-3476
Phone (606) 677-2913
75 Hail Knob Rd
Somerset, KY 42503-3434
Phone (606) 678-9617
Hospital & facility affiliations
- Lake Cumberland Regional Hospital
- Saint Joseph London
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241231001259 | KY | Practitioner - Physician Assistant | 1658808787 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Cumberland Physician Practices LLC | Physician Assistant | Current |
Accepting new patients |
| Lake Cumberland Physician Practices LLC | Physician Assistant | Current |
Accepting new patients |
| Lake Cumberland Surgery Center LP | Past | Accepting new patients |
Locations
30 Tower Cir
Somerset, KY 42503
Phone (606) 451-8644
305 Medpark Dr
Somerset, KY 42503
Phone (606) 263-2912
75 Hail Knob Rd
Somerset, KY 42503
Phone (606) 678-9617
330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780
Interoperability endpoints
- https://97465a19-0dc7-4ef3-9aea-f72e472d3305.gastro.prod.fhir.ema-api.com/fhir/r4/
- kyle.hopper.1@21269.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
101 Neth Dr
Milligan, TN 37682-3015
Mailing address
531 Calvin Phillips Dr
Johnson City, TN 37601-6445
Other providers in Milligan, TN
All providers in Milligan, TN · Physician Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.