Individual provider Active NPI

Tina A. Rose, NP

  • Family Nurse Practitioner
  • Kingsport, TN
National Provider Identifier
1174064950
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22402 Issued in TN
Practice address
2050 Meadowview Pkwy
Kingsport, TN 37660-7475
Phone
(423) 230-5000
Fax
(423) 230-5035
NPI assigned
Mar 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 209432 TN
Family Nurse Practitioner 363LF0000X 0024174660 VA
Family Nurse Practitioner 363LF0000X 22402 TN Primary

Addresses

Primary practice location

2050 Meadowview Pkwy
Kingsport, TN 37660-7475

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

115 Judge Gresham Rd Ste A
Gray, TN 37615-6213
Phone (423) 467-3000

Other practice location 2

271 Medical Park Blvd
Bristol, TN 37620-7455
Phone (423) 274-8600

Other practice location 3

671 Highway 58 E
Norton, VA 24273-3007
Phone (276) 679-5874

Other practice location 4

743 Island Rd
Bristol, VA 24201-7403
Phone (276) 469-4200

Other practice location 5

1490 Park Ave NW Ste 3C
Norton, VA 24273-1631
Phone (276) 679-0252

Other practice location 6

127 Health Care Dr Ste 3
Pennington Gap, VA 24277-2853
Phone (423) 230-5000

Other practice location 7

1500 W Elk Ave
Elizabethton, TN 37643-2654
Phone (423) 543-2584

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
I20170425000427 TN Practitioner - Nurse Practitioner 8224314497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Care PLLCGroup PAC ID 1850448580, 40 clinicians

Practice addresses (Care Compare)

1500 W Elk Ave
Elizabethton, TN 37643-3776
Phone (423) 543-2584

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209432TNMDRegistered Nurse
22402TNMDFamily Nurse Practitioner
0024174660VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care PLLC CurrentSince Jan 21, 2025 Accepting new patients
Wellmont Medical Associates, Inc. PastSince Sep 1, 2019 Accepting new patients

Locations

401 E Main St
Johnson City, TN 37601
Phone (423) 722-2062

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": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1174064950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 MEADOWVIEW PKWY",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607475",
            "telephone_number": "423-230-5000",
            "fax_number": "423-230-5035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Judge Gresham Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Gray",
            "state": "TN",
            "postal_code": "376156213",
            "country_code": "US",
            "telephone_number": "423-467-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "271 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207455",
            "country_code": "US",
            "telephone_number": "423-274-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "671 Highway 58 E",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242733007",
            "country_code": "US",
            "telephone_number": "276-679-5874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "743 Island Rd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "VA",
            "postal_code": "242017403",
            "country_code": "US",
            "telephone_number": "276-469-4200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1490 Park Ave NW Ste 3C",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242731631",
            "country_code": "US",
            "telephone_number": "276-679-0252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "127 Health Care Dr Ste 3",
            "address_purpose": "LOCATION",
            "city": "Pennington Gap",
            "state": "VA",
            "postal_code": "242772853",
            "country_code": "US",
            "telephone_number": "423-230-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 W Elk Ave",
            "address_purpose": "LOCATION",
            "city": "Elizabethton",
            "state": "TN",
            "postal_code": "376432654",
            "country_code": "US",
            "telephone_number": "423-543-2584",
            "fax_number": "423-722-2060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "TINA",
        "middle_name": "A.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "209432",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174660",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.