Individual provider Active NPI

Bethany Monique Rock, FNP

  • Family Nurse Practitioner
  • Mountain City, TN
National Provider Identifier
1235641630
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23274 Issued in TN
Practice address
5249 Highway 67 W
Mountain City, TN 37683-6471
Phone
(423) 727-7387
Fax
(423) 727-4532
NPI assigned
Oct 26, 2017
Last updated
Nov 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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 23274 TN Primary

Addresses

Primary practice location

5249 Highway 67 W
Mountain City, TN 37683-6471

Mailing address

3716 Thorngrove Dr
Kingsport, TN 37660-2243
Phone (423) 765-6303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA, KY3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20211111001905 TN Practitioner - Nurse Practitioner 1850796137 Reassigns benefits to 1 organization
Practice locations: Johnson City, TN
I20220504000867 VA Practitioner - Nurse Practitioner 1850796137 Reassigns benefits to 1 organization
I20230612002151 KY Practitioner - Nurse Practitioner 1850796137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrated Wound Care Tennessee PLLCGroup PAC ID 8527394477, 19 clinicians
Integrated Wound Care Virginia PLLCGroup PAC ID 2365875390, 7 clinicians

Practice addresses (Care Compare)

141 N McLean Blvd
Memphis, TN 38104-2693
Phone (201) 870-1194

324 King George Ave SW
Roanoke, VA 24016-5213
Phone (718) 705-6010

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
78.01

Merit-based Incentive Payment System (MIPS)

Final score
62.21 of 100Reported as group
Quality
79.66
Promoting interoperability
0
Improvement activities
20
Cost
69.39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Wound Care Kentucky PLLC CurrentSince May 7, 2023 Accepting new patients
Integrated Wound Care Tennessee PLLC CurrentSince Sep 1, 2021 Accepting new patients
Integrated Wound Care Virginia PLLC CurrentSince Mar 12, 2022 Accepting new patients

Locations

492C Cedar Ln
Teaneck, NJ 07666
Phone (201) 357-5468

141 N McLean Blvd
Memphis, TN 38104
Phone (901) 276-2021

324 King George Ave SW
Roanoke, VA 24016
Phone (540) 309-9895

Organizations & group practices 3

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": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1235641630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 THORNGROVE DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376602243",
            "telephone_number": "423-765-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5249 HIGHWAY 67 W",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376836471",
            "telephone_number": "423-727-7387",
            "fax_number": "423-727-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCK",
        "first_name": "BETHANY",
        "middle_name": "MONIQUE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-26",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "23274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain City, TN

Sources for this page

Verify at the official NPI Registry.