Hermitage Family Practice LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

HERMITAGE FAMILY PRACTICE LLC

Practice address

4243 Lebanon Pike Ste a
Hermitage, TN 37076-2170

Phone

(615) 874-9888

Fax

(615) 883-6899

NPI assigned

Feb 1, 2022

Last updated

Jun 29, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jill Welbern

Title

Owner

Phone

(615) 874-9888

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jill Welbern Tibbetts, FNP

  • Family Nurse Practitioner
  • Hermitage, TN
  • NPI 1609363597
  Medicare reassignment Care Compare group NPD
• Grant Anderson, PA-C

  • Physician Assistant
  • Hendersonville, TN
  • NPI 1003279589
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1245983030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4243 LEBANON PIKE STE A",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762170",
            "telephone_number": "615-874-9888",
            "fax_number": "615-883-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4243 LEBANON PIKE STE A",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762170",
            "telephone_number": "615-874-9888",
            "fax_number": "615-883-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERMITAGE FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-01",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "WELBERN",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-874-9888"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hermitage Eye Care PLLC
• Hermitage Family & Cosmetic Dentistry, P.C.
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• Hermitage Modern Dentistry, PC (Hermitage Modern Dentistry)
• Hermitage Nursing & Rehabilitation Center LLC
• Hermitage Pediatric Dentistry

• Family Nurse Practitioner in Hermitage, TN
• Providers in Hermitage, 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 Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.