Individual provider Active NPI

Penny L Welker

  • Family Nurse Practitioner
  • Jefferson City, TN
National Provider Identifier
1174921258
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19412 Issued in TN
Practice address
1004 N Highway 92 Ste B
Jefferson City, TN 37760-3687
Phone
(865) 647-3400
Fax
(865) 647-3401
NPI assigned
Dec 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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 19412 TN Primary

Addresses

Primary practice location

1004 N Highway 92 Ste B
Jefferson City, TN 37760-3687

Mailing address

1004 N Highway 92 Ste B
Jefferson City, TN 37760-3687
Phone (865) 647-3400

Other identifiers 1

IdentifierTypeStateIssuer
Q014367MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address penny.welker.1@4694.direct.athenahealth.com

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
I20150323001725 TN Practitioner - Nurse Practitioner 2264759612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knoxville Hma Physician Management, LLCGroup PAC ID 6103097316, 118 clinicians

Practice addresses (Care Compare)

1004 N Hwy 92
Suite B
Jefferson City, TN 37760-3687
Phone (865) 262-9226

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as apm
Quality
73.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Knoxville Hma Physician Management, LLC Family CurrentSince Nov 15, 2019 Accepting new patients

Locations

1004 N Highway 92
Ste B
Jefferson City, TN 37760
Phone (865) 262-9226

1405 S Sizer Ave
Ste E
Jefferson City, TN 37760
Phone (865) 475-5377

120 Hospital Dr
Ste 100
Jefferson City, TN 37760
Phone (865) 471-2570

10810 Parkside Dr
Ste G-11
Knoxville, TN 37934
Phone (865) 218-6660

434 4th St
Ste 305
Newport, TN 37821
Phone (423) 415-3282

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4694/brand/1/csg/1/fhir/r4
  • Direct secure messaging: penny.welker.2@4694.direct.athenahealth.com
  • Direct secure messaging: penny.welker.1@4694.direct.athenahealth.com

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 4

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": "1417737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1174921258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 N HIGHWAY 92 STE B",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377603687",
            "telephone_number": "865-647-3400",
            "fax_number": "865-647-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 N HIGHWAY 92 STE B",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377603687",
            "telephone_number": "865-647-3400",
            "fax_number": "865-647-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELKER",
        "first_name": "PENNY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-05",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "19412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q014367",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "penny.welker.1@4694.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "1004 N Highway 92 Ste B",
            "city": "Jefferson City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377603687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jefferson City, TN

Sources for this page

Verify at the official NPI Registry.