Individual provider Active NPI

William McSherry Hennage, FNP-BC

  • Family Nurse Practitioner
  • Greeneville, TN
National Provider Identifier
1154601508
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202098 Issued in TN
Practice address
60 Shiloh Road
Greeneville, TN 37743-6027
Phone
(423) 636-7438
NPI assigned
Aug 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 771025 TX
Family Nurse Practitioner 363LF0000X 202098 TN Primary

Addresses

Primary practice location

60 Shiloh Road
Greeneville, TN 37743-6027

Mailing address

105 W Stone Dr
Suite 6a
Kingsport, TN 37660-3365
Phone (423) 408-7220

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
I20151110002529 TN Practitioner - Nurse Practitioner 5698990174 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202098TNMDFamily Nurse Practitioner
771025TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. CurrentSince Dec 1, 2015 Accepting new patients
Wellmont Medical Associates Inc CurrentSince Dec 1, 2015 Accepting new patients

Locations

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

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": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154601508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W STONE DR",
            "address_2": "SUITE 6A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-408-7220",
            "fax_number": "423-408-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 SHILOH ROAD",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377436027",
            "telephone_number": "423-636-7438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNAGE",
        "first_name": "WILLIAM",
        "middle_name": "MCSHERRY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "771025",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "202098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeneville, TN

Sources for this page

Verify at the official NPI Registry.