Individual provider Active NPI

Alysa C Werkheiser-Quillen, APRN

  • Primary Care Nurse Practitioner
  • Mountain Home, TN
National Provider Identifier
1154930402
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
27839 Issued in TN
Practice address
Sidney and Lamont Streets
Mountain Home, TN 37684
Phone
(423) 926-1171
NPI assigned
Jul 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 27839 TN Primary

Addresses

Primary practice location

Sidney and Lamont Streets
Mountain Home, TN 37684

Mailing address

669 Big Hollow Rd
Blountville, TN 37617-5332
Phone (423) 341-5528

Other practice location 1

101 Dogwood Ave
Mountain Home, TN 37684
Phone (423) 926-1171 ext. 5868

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL alysa.werkheiser-quillen@va.gov Health Information Exchange (HIE) Mountain Home VAMC
CONNECT URL alysa.werkheiser-quillen@va.gov Health Information Exchange (HIE) Mountain Home VAMC
CONNECT URL alysa.werkheiser-quillen@va.gov Health Information Exchange (HIE) Mountain Home VAMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27839TNMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1154930402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 BIG HOLLOW RD",
            "city": "BLOUNTVILLE",
            "state": "TN",
            "postal_code": "376175332",
            "telephone_number": "423-341-5528",
            "fax_number": "423-979-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SIDNEY AND LAMONT STREETS",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "37684",
            "telephone_number": "423-926-1171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Dogwood Ave",
            "address_purpose": "LOCATION",
            "city": "Mountain Home",
            "state": "TN",
            "postal_code": "37684",
            "country_code": "US",
            "telephone_number": "423-926-1171 x5868",
            "fax_number": "423-979-3028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WERKHEISER-QUILLEN",
        "first_name": "ALYSA",
        "middle_name": "C",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2023-11-27",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "27839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "alysa.werkheiser-quillen@va.gov",
            "affiliation": "Y",
            "endpointDescription": "Government email",
            "affiliationName": "Mountain Home VAMC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "Sidney and Lamont Streets",
            "city": "Mountain Home",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376844000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "alysa.werkheiser-quillen@va.gov",
            "affiliation": "Y",
            "endpointDescription": "Government email",
            "affiliationName": "Mountain Home VAMC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "Sidney and Lamont Streets",
            "city": "Mountain Home",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376844000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "alysa.werkheiser-quillen@va.gov",
            "affiliation": "Y",
            "endpointDescription": "Government email",
            "affiliationName": "Mountain Home VAMC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "Sidney and Lamont Streets",
            "city": "Mountain Home",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376844000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mountain Home, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.