Individual provider Active NPI

Elizabeth Margaret Urcinole, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Clarksville, TN
National Provider Identifier
1124850466
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
36721 Issued in TN
Practice address
315 Congressman Dr
Clarksville, TN 37042-1325
Phone
(629) 210-4248
NPI assigned
Aug 15, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 36721 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 36721 TN Primary

Addresses

Primary practice location

315 Congressman Dr
Clarksville, TN 37042-1325

Mailing address

365 S Hartmann Dr Ste 102
Lebanon, TN 37087-4788
Phone (931) 288-4619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241031003981 KY Practitioner - Nurse Practitioner 2860925658 Reassigns benefits to 1 organization
I20250429003185 TN Practitioner - Nurse Practitioner 2860925658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Roundtree Mental Health Group PLLCGroup PAC ID 8628415817, 2 clinicians

Practice addresses (Care Compare)

142 Public SQ
Suite E104
Lebanon, TN 37087-2871
Phone (931) 288-4619

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36721TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roundtree Mental Health Group PLLC Single Specialty CurrentSince Apr 23, 2025 Accepting new patients
Abs Lincs Ky, LLC Single Specialty CurrentSince Sep 7, 2024 Accepting new patients

Locations

270 Walton Way
Hopkinsville, KY 42240
Phone (270) 886-1919

142 Public Sq
Ste E104
Lebanon, TN 37087
Phone (931) 288-4619

365 S Hartmann Dr
Ste 102
Lebanon, TN 37087
Phone (615) 444-0854

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": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1124850466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 S HARTMANN DR STE 102",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370874788",
            "telephone_number": "931-288-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 CONGRESSMAN DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370421325",
            "telephone_number": "629-210-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URCINOLE",
        "first_name": "ELIZABETH",
        "middle_name": "MARGARET",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "36721",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "36721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.