Individual provider Active NPI

Kyle Jeffrey Charnley, NP

  • Family Nurse Practitioner
  • Crossville, TN
National Provider Identifier
1114740040
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
37281 Issued in TN
Practice address
665 N Main St
Crossville, TN 38555-6206
Phone
(931) 337-0510
NPI assigned
Nov 7, 2024
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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 37281 TN Primary

Addresses

Primary practice location

665 N Main St
Crossville, TN 38555-6206

Mailing address

665 N Main St
Crossville, TN 38555-6206
Phone (931) 337-0510

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250113001989 TN Practitioner - Nurse Practitioner 5890223242 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Katherine Stone DO PLLCGroup PAC ID 5294119863, 2 clinicians
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

1645 S Main St
Suite 101
Crossville, TN 38555-2908
Phone (931) 484-7531

665 N Main St
Crossville, TN 38555-6206
Phone (931) 337-0510

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37281TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Oct 28, 2024 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Oct 28, 2024 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients

Locations

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

665 N Main St
Crossville, TN 38555
Phone (931) 337-0510

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1114740040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 N MAIN ST",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385556206",
            "telephone_number": "931-337-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 N MAIN ST",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385556206",
            "telephone_number": "931-337-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARNLEY",
        "first_name": "KYLE",
        "middle_name": "JEFFREY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "37281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

Verify at the official NPI Registry.