Individual provider Active NPI

Michelle D Snodgrass, NP

  • Family Nurse Practitioner
  • Kingsport, TN
National Provider Identifier
1154693091
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16497 Issued in TN
Practice address
4848 Fort Henry Dr
Kingsport, TN 37663-3347
Phone
(423) 239-5141
Fax
(423) 239-4869
NPI assigned
Feb 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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 0024169879 VA
Family Nurse Practitioner 363LF0000X 16497 TN Primary

Addresses

Primary practice location

4848 Fort Henry Dr
Kingsport, TN 37663-3347

Mailing address

PO Box 9
Kingsport, TN 37662-0009
Phone (423) 857-2093

Other practice location 1

308 8th St
Bristol, TN 37620-2386
Phone (423) 844-6860

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
I20120224000457 TN Practitioner - Nurse Practitioner 0941468722 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holston Medical Group PCGroup PAC ID 8224935754, 239 clinicians

Practice addresses (Care Compare)

4848 Fort Henry Dr
Kingsport, TN 37663-3347
Phone (423) 239-5141

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16497TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holston Medical Group PC CurrentSince Dec 10, 2020 Accepting new patients
Wellmont Medical Associates Inc Current Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Jul 1, 2012 Accepting new patients

Locations

308 8th St
Bristol, TN 37620
Phone (423) 844-6860

350 Steeles Rd
#1
Bristol, TN 37620
Phone (423) 844-4925

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

105 W Stone Dr
Ste 1F
Kingsport, TN 37660
Phone (423) 230-2420

4848 Fort Henry Dr
Kingsport, TN 37663
Phone (423) 239-5141

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

851 Locust St
Rogersville, TN 37857
Phone (423) 272-2671

391 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-4406

Interoperability endpoints

  • Direct secure messaging: michellesnodgrass@hmgpath.allscriptsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1154693091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376620009",
            "telephone_number": "423-857-2093",
            "fax_number": "423-390-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4848 FORT HENRY DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633347",
            "telephone_number": "423-239-5141",
            "fax_number": "423-239-4869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "308 8th St",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376202386",
            "country_code": "US",
            "telephone_number": "423-844-6860",
            "fax_number": "423-844-0613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNODGRASS",
        "first_name": "MICHELLE",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024169879",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "16497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.