Individual provider Active NPI

Judith L Day, FNP

  • Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1205390747
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F01191311 Issued in TN
Practice address
301 Med Tech Pkwy Ste 240
Johnson City, TN 37604-2641
Phone
(423) 794-5520
Fax
(423) 282-6940
NPI assigned
Jan 29, 2019
Last updated
Apr 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F01191311 TN Primary
Registered Nurse 163W00000X 187836 TN

Addresses

Primary practice location

301 Med Tech Pkwy Ste 240
Johnson City, TN 37604-2641

Mailing address

215 E Springbrook Dr
Johnson City, TN 37601-1761
Phone (423) 794-5520

Other identifiers 2

IdentifierTypeStateIssuer
087100111MedicaidTN
Q050171MedicaidTN

Other names 1

  • Judith L Larkins Former name

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
I20190913001706 TN Practitioner - Nurse Practitioner 3173852381 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
East Tennessee State University Quillen College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

291 S Daisy St
Morristown, TN 37813-2362
Phone (423) 616-8315

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
187836TNMDRegistered Nurse
25583TNMDGeneral Practice Physician
F01191311TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Jul 20, 2020 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jul 20, 2020 Accepting new patients
Upperline Healthcare, PC CurrentSince Nov 1, 2025 Accepting new patients
Upperline Healthcare, PC Nurse Practitioner CurrentSince Nov 1, 2025 Accepting new patients
State of Franklin Healthcare Associates PLLC PastSince Aug 18, 2019 Accepting new patients

Locations

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

3430 E Andrew Johnson Hwy
Greeneville, TN 37745
Phone (423) 820-0033

291 S Daisy St
Morristown, TN 37813
Phone (423) 616-8315

2280 S Shady St
Mountain City, TN 37683
Phone (423) 501-2165

441 S Illinois Ave
Oak Ridge, TN 37830
Phone (865) 685-0767

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1205390747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E SPRINGBROOK DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011761",
            "telephone_number": "423-794-5520",
            "fax_number": "423-282-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MED TECH PKWY STE 240",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042641",
            "telephone_number": "423-794-5520",
            "fax_number": "423-282-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAY",
        "first_name": "JUDITH",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-29",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "F01191311",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "187836",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087100111",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q050171",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "LARKINS",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.