NPIMap

Individual provider Active NPI

Kelly Hyder, FNP-C

  • Family Nurse Practitioner
  • Greeneville, TN
National Provider Identifier
1245798107
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
24819 Issued in TN
Practice address
1665 E Andrew Johnson Hwy Ste 2
Greeneville, TN 37745-5826
Phone
(423) 639-0243
Fax
(423) 639-0628
NPI assigned
Mar 8, 2019
Last updated
Feb 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 24819 TN Primary

Addresses

Primary practice location

1665 E Andrew Johnson Hwy Ste 2
Greeneville, TN 37745-5826

Mailing address

6016 Brookvale LN Ste 200
Knoxville, TN 37919-4003
Phone (865) 862-0998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190925002941 TN Practitioner - Nurse Practitioner 4183954647 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1665 E Andrew Johnson Hwy
Suite 2
Greeneville, TN 37745-5826
Phone (423) 639-0243

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Pac Healthcare Services of Tennessee PC CurrentSince Apr 3, 2023 Accepting new patients
CS Pacs 3 Southeast, LLC CurrentSince Jul 16, 2024 Accepting new patients
SBH-Kingsport CurrentSince Jul 20, 2019 Accepting new patients
NV Pacs 2 LLC CurrentSince Apr 3, 2023 Accepting new patients
SBH-Kingsport CurrentSince Jul 20, 2019 Accepting new patients
Tennessee Cancer Specialists PLLC CurrentSince Mar 4, 2025 Accepting new patients
Tennessee Cancer Specialist PLLC CurrentSince Mar 4, 2025 Accepting new patients
Medpsych Inc. PC CurrentSince May 9, 2022 Accepting new patients
Mobile Images Acquisition, LLC Past Accepting new patients

Locations

880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669

1410 Tusculum Blvd
Ste 2200
Greeneville, TN 37745
Phone (423) 639-0243

1665 E Andrew Johnson Hwy
Ste 2
Greeneville, TN 37745
Phone (423) 639-0243

1301 Sunset Dr
Ste 3
Johnson City, TN 37604
Phone (423) 588-7130

1025 Executive Park Blvd
Kingsport, TN 37660
Phone (423) 765-0777

4 Sheridan Sq
Ste 102
Kingsport, TN 37660
Phone (423) 246-8196

1415 Old Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 934-5806

6016 Brookvale Ln
Ste 200
Knoxville, TN 37919
Phone (865) 862-0998

900 E Hill Ave
Ste 230
Knoxville, TN 37915
Phone (865) 862-0998

7551 Dannaher Dr
Powell, TN 37849
Phone (865) 637-9330

Organizations & group practices 9

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.

Hospital & facility affiliations 4

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": "1552003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1245798107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6016 BROOKVALE LN STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194003",
            "telephone_number": "865-862-0998",
            "fax_number": "865-544-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 E ANDREW JOHNSON HWY STE 2",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377455826",
            "telephone_number": "423-639-0243",
            "fax_number": "423-639-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDER",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-08",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "24819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeneville, TN

Sources for this page

Verify at the official NPI Registry.