Individual provider Active NPI

Hanna Marie King, FNP-C

  • Family Nurse Practitioner
  • Crossville, TN
National Provider Identifier
1164375762
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
41135 Issued in TN
Practice address
1264 Dayton Ave
Crossville, TN 38555-6175
Phone
(931) 484-4560
Fax
(931) 484-1480
NPI assigned
Feb 16, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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 41135 TN Primary

Addresses

Primary practice location

1264 Dayton Ave
Crossville, TN 38555-6175

Mailing address

1264 Dayton Ave
Crossville, TN 38555-6175
Phone (931) 484-4560

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
I20260320004062 TN Order and Referring Only - Family PracticePractitioner - Family Practice 4385128974

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Victor a. Shada, D.O., P.C.Group PAC ID 2365532553, 2 clinicians

Practice addresses (Care Compare)

1264 Dayton Ave
Crossville, TN 38555-6175
Phone (931) 484-4560

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41135TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Victor a. Shada, D.O., P.C. Family Medicine CurrentSince May 26, 2026 Accepting new patients

Locations

396 S Main St
Crossville, TN 38555
Phone (931) 484-4560

1264 Dayton Ave
Crossville, TN 38555
Phone (931) 484-4560

Organizations & group practices 1

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 1

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": "1771200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1164375762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 DAYTON AVE",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385556175",
            "telephone_number": "931-484-4560",
            "fax_number": "931-484-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 DAYTON AVE",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385556175",
            "telephone_number": "931-484-4560",
            "fax_number": "931-484-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "HANNA",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-16",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "41135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

Verify at the official NPI Registry.