Individual provider Active NPI

Wanda A. Lancaster, FNP-BC

  • Family Nurse Practitioner
  • Pigeon Forge, TN
National Provider Identifier
1104932029
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN7565 Issued in TN
Practice address
415 Cole Dr
Pigeon Forge, TN 37863-3775
Phone
(865) 428-5454
Fax
(865) 429-5616
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 APN7565 TN Primary

Addresses

Primary practice location

415 Cole Dr
Pigeon Forge, TN 37863-3775

Mailing address

711 Signal Mountain Rd # 304
Chattanooga, TN 37405-1823
Phone (865) 360-4919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN7565TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blount Memorial Physician Group, Inc CurrentSince Jan 1, 2011 Accepting new patients
Alaska Kidney & Diabetes Association Past Accepting new patients

Locations

463 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5100

458 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5355

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1104932029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 SIGNAL MOUNTAIN RD # 304",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374051823",
            "telephone_number": "865-360-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 COLE DR",
            "city": "PIGEON FORGE",
            "state": "TN",
            "postal_code": "378633775",
            "telephone_number": "865-428-5454",
            "fax_number": "865-429-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCASTER",
        "first_name": "WANDA",
        "middle_name": "A.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN7565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pigeon Forge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.