Individual provider Active NPI

Kelly Dry

  • Family Nurse Practitioner
  • Oak Ridge, TN
National Provider Identifier
1215707732
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
34741 Issued in TN
Practice address
200 New York Ave Ste 330
Oak Ridge, TN 37830-5225
Phone
(865) 483-7511
Fax
(865) 483-7959
NPI assigned
Jan 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 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 34741 TN Primary

Addresses

Primary practice location

200 New York Ave Ste 330
Oak Ridge, TN 37830-5225

Mailing address

200 New York Ave Ste 330
Oak Ridge, TN 37830-5225
Phone (865) 483-7511

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
I20240308002970 TN Practitioner - Nurse Practitioner 9931545258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Lincoln Memorial University Medical Department, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrocare Tennessee PLLCGroup PAC ID 2961626270, 2 clinicians

Practice addresses (Care Compare)

200 New York Ave
West Mall Medical Park Suite 330
Oak Ridge, TN 37830-5212
Phone (865) 483-7511

200 New York Ave 330 W Mall Medical PA
West Mall Medical Park Suite 330
Oak Ridge, TN 37830-5212

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrocare Tennessee PLLC CurrentSince Feb 19, 2024 Accepting new patients

Locations

200 New York Ave
Ste 330
Oak Ridge, TN 37830
Phone (865) 482-8944

200 New York Ave
Oak Ridge, TN 37830
Phone (865) 483-7511

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 2

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": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1215707732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEW YORK AVE STE 330",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378305225",
            "telephone_number": "865-483-7511",
            "fax_number": "865-483-7959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NEW YORK AVE STE 330",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378305225",
            "telephone_number": "865-483-7511",
            "fax_number": "865-483-7959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRY",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "34741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.