Individual provider Active NPI

Shelley Hilton, FNP

  • Family Nurse Practitioner
  • Kingsport, TN
National Provider Identifier
1245352350
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN12632 Issued in TN
Practice address
2300 W Stone Dr
Kingsport, TN 37660-2360
Phone
(423) 246-4961
Fax
(423) 245-3136
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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 APN12632 TN Primary

Addresses

Primary practice location

2300 W Stone Dr
Kingsport, TN 37660-2360

Mailing address

2408 Susannah St
Ste 1
Johnson City, TN 37601-1728
Phone (423) 282-5054

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
I20070809000536 TN Practitioner - Nurse Practitioner 1456442136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
East Tennessee State University Quillen College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates, P.C.Group PAC ID 3971578816, 26 clinicians

Practice addresses (Care Compare)

2300 W Stone Dr
Kingsport, TN 37660-2360
Phone (423) 246-4961

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12632TNMDSocial Worker
APN12632TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates, P.C. CurrentSince Jun 24, 2013 Accepting new patients
Tri-State Cardiology Past Accepting new patients

Locations

3183 W State St
Ste 1102
Bristol, TN 37620
Phone (423) 764-7131

2885 Boones Creek Rd
Johnson City, TN 37615
Phone (423) 928-9014

2300 W Stone Dr
Kingsport, TN 37660
Phone (423) 246-4961

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1245352350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 SUSANNAH ST",
            "address_2": "STE 1",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011728",
            "telephone_number": "423-282-5054",
            "fax_number": "423-262-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W STONE DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376602360",
            "telephone_number": "423-246-4961",
            "fax_number": "423-245-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILTON",
        "first_name": "SHELLEY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN12632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.