Victoria Brooke Ivy, FNP-C
Individual provider Active NPI Family Nurse Practitioner · MC Kenzie, TN
NPI 1235918947 · NPPES record last updated Sep 22, 2023
Key facts
- NPI
- 1235918947
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 34621 (TN)
- Practice address
- 1894 Cedar St
MC Kenzie, TN 38201-2206 - Phone
- (731) 207-6496
- NPI assigned
- Sep 22, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 17
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fast Pace Medical Clinic PLLC
Practice addresses (Care Compare)
108 Courtright Rd
Martin, TN 38237-1607
Phone (615) 988-1571
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231018000268 | TN | Practitioner - Nurse Practitioner | 0244685741 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients |
Locations
7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038
108 Courtright Rd
Martin, TN 38237
Phone (731) 281-4183
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 34621 | TN | Yes |
Addresses
Primary practice location
1894 Cedar St
MC Kenzie, TN 38201-2206
Mailing address
273 Mebanewood Dr
Huntingdon, TN 38344-2910
Phone (731) 415-0364
Other names
- Victoria McQuesten
Other providers in MC Kenzie, TN
- Home Medical Products, Inc
- Laura Alessandra Horner
- Francis Howe
- Bruce Lee Ingmire
- Integrative Health Centers of Kentucky LLC
- J. B. Johnsonius, D.D.S.
- Gyu Chang Jo
- John E Motheral
- Tamiko Johns
- David Andrew Johnson
All providers in MC Kenzie, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.