Kristina Ann Roark, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

22679 Issued in TN

Practice address

1913 Highway 394
Blountville, TN 37617-5349

Phone

(423) 662-7002

Fax

(423) 662-7003

NPI assigned

Mar 17, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY, TN2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fast Pace Kentucky, PLLCGroup PAC ID 0143525998, shared by 46 NPIs, 213 clinicians

Brock Medical, LLCGroup PAC ID 9830354638, 93 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Brock Medical, LLC

  • Nurse Practitioner
  • London, KY
  • NPI 1023379815
  Medicare reassignment Care Compare group NPD
• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  Medicare reassignment NPD
• Fast Pace Kentucky PLLC

  • Family Nurse Practitioner
  • Franklin, KY
  • NPI 1457716706
  Medicare reassignment NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  KY, TN

  Medicare reassignment NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Fast Pace Kentucky PLLC

  • Rural Health Clinic/Center
  • Corbin, KY
  • NPI 1669256913
  NPD
• Fast Pace Kentucky, PLLC

  • Rural Health Clinic/Center
  • Spindale, NC
  • NPI 1942027891
  NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843
  NPD
• Fast Pace Kentucky, PLLC

  • Rural Health Clinic/Center
  • Bardstown, KY
  • NPI 1184381444
  NPD (past)

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1235438144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 HIGHWAY 394",
            "city": "BLOUNTVILLE",
            "state": "TN",
            "postal_code": "376175349",
            "telephone_number": "423-662-7002",
            "fax_number": "423-662-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 HIGHWAY 394",
            "city": "BLOUNTVILLE",
            "state": "TN",
            "postal_code": "376175349",
            "telephone_number": "423-662-7002",
            "fax_number": "423-662-7003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "81 Ball Park Rd",
            "address_purpose": "LOCATION",
            "city": "Harlan",
            "state": "KY",
            "postal_code": "408311701",
            "country_code": "US",
            "telephone_number": "606-573-7322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROARK",
        "first_name": "KRISTINA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-17",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3006867",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Pigeon, OD
• Courtney Marie Price, RN
• Regen, Smith and Smith, LLC
• Mary Ellen Hall Ress, R.N.
• Gabriella Alexis Rivera
• Julie G Roberts, RN
• Shelby Rowe
• Brittany Danielle Shortridge
• Ricky Dale Showman Jr.
• Taylor Nicole Skeens, RN

• Family Nurse Practitioner in Blountville, TN
• Providers in Blountville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.