Mitzi Serena Carrea, FNP-C, RN-NIC
Individual provider Active NPI Family Nurse Practitioner · Dunlap, TN
NPI 1114403003 · NPPES record last updated Jul 14, 2018
Key facts
- NPI
- 1114403003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 24442 (TN)
- Practice address
- 74 Wheeler Ridge Rd
Dunlap, TN 37327-4792 - Phone
- (904) 652-9890
- NPI assigned
- Jul 14, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 17
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- East Tennessee State University Quillen College of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fast Pace Medical Clinic PLLC
Practice addresses (Care Compare)
7449 State Route 28
Dunlap, TN 37327-3564
Phone (423) 443-3262
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- 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 |
|---|---|---|---|---|
| I20200330003175 | TN | Practitioner - Nurse Practitioner | 6305275108 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients |
Locations
7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038
7449 State Route 28
Dunlap, TN 37327
Phone (423) 443-3262
931 Old Smithville Rd
McMinnville, TN 37110
Phone (931) 259-4144
910 New Highway 68
Sweetwater, TN 37874
Phone (423) 836-9304
9002 Sparta Pike
Watertown, TN 37184
Phone (615) 697-6836
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 24442 | TN | Yes |
Addresses
Primary practice location
74 Wheeler Ridge Rd
Dunlap, TN 37327-4792
Mailing address
74 Wheeler Ridge Rd
Dunlap, TN 37327-4792
Phone (904) 652-9890
Other providers in Dunlap, TN
- Lisa Ann Brown
- Tanner Bryant
- Brett Aaron Cagle
- Caring Hearts of Dunlap
- Katelyn Roberta Carpenter
- Madilyn Cartwright
- Jenna Brooke Cate
- Cates Street Pharmacy LLC
- County of Sequatchie Office
- Covenant Medcare LLC
All providers in Dunlap, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2018. 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.