Individual provider Active NPI

Virginia Leshea Pate

  • Family Nurse Practitioner
  • Sevierville, TN
National Provider Identifier
1124320916
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15490 Issued in TN
Practice address
1115 Blanton Dr
Sevierville, TN 37862
Phone
(865) 453-4434
Fax
(866) 610-2903
NPI assigned
Nov 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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 15490 TN Primary

Addresses

Primary practice location

1115 Blanton Dr
Sevierville, TN 37862

Mailing address

PO Box 15004
Knoxville, TN 37901-5004
Phone (865) 541-8895

Other identifiers 1

IdentifierTypeStateIssuer
1522075MedicaidTN

Other names 1

  • Virginia Leshea Mutter Former name

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
I20110308000030 TN Practitioner - Nurse Practitioner 8123200581 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, shared by 15 NPIs, 737 clinicians

Practice addresses (Care Compare)

100 E Tennessee St
Collinwood, TN 38450
Phone (931) 724-9000

2960 Winfield Dunn Pkwy
Kodak, TN 37764-4309
Phone (865) 213-7104

4696 Nashville Hwy
Chapel Hill, TN 37034-2110
Phone (931) 364-5321

5326 Western Ave
Knoxville, TN 37921-3203
Phone (865) 500-6526

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15490TNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Jul 30, 2021 Accepting new patients
Upperline Healthcare, PC Nurse Practitioner CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jul 30, 2021 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Mountain Valley RX 05 Inc Past Accepting new patients
Instacare PLLC PastSince Aug 25, 2020 Accepting new patients
Emergency Coverage Services, PC Nurse Practitioner Past Accepting new patients
Westin Clinic, P.C. Past Accepting new patients

Locations

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

3430 E Andrew Johnson Hwy
Greeneville, TN 37745
Phone (423) 820-0033

2019 Jacksboro Pike
La Follette, TN 37766
Phone (423) 437-3093

2280 S Shady St
Mountain City, TN 37683
Phone (423) 501-2165

756 Cosby Hwy
Newport, TN 37821
Phone (423) 237-6546

1181 Dolly Parton Pkwy
Sevierville, TN 37862
Phone (865) 446-1433

Organizations & group practices 8

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": "1291075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1124320916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15004",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379015004",
            "telephone_number": "865-541-8895",
            "fax_number": "865-633-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BLANTON DR",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "37862",
            "telephone_number": "865-453-4434",
            "fax_number": "866-610-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATE",
        "first_name": "VIRGINIA",
        "middle_name": "LESHEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-30",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "15490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1522075",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIRGINIA",
            "last_name": "MUTTER",
            "middle_name": "LESHEA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sevierville, TN

Sources for this page

Verify at the official NPI Registry.