Wesley Allen Stickley, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

29975 Issued in TN

Practice address

2002 Brookside Dr Ste 102
Kingsport, TN 37660-4634

Phone

(423) 245-6000

Fax

(423) 245-4190

NPI assigned

Jul 28, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wstickley34525@direct.acumenmd.com

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.

• Regional Kidney Care, PC

  • Specialist
  • Kingsport, TN
  • NPI 1073638144
  Medicare reassignment NPD

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1265105951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 MEADOW VIEW RD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376209509",
            "telephone_number": "276-591-6308",
            "fax_number": "423-245-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 BROOKSIDE DR STE 102",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604634",
            "telephone_number": "423-245-6000",
            "fax_number": "423-245-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKLEY",
        "first_name": "WESLEY",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "29975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William J Steptoe, MD
• Steven L. Cureton, DMD, Ms
• Christy Lenore Stevens, DO
• Leslie Esther Stevens, PA
• Laura Evelyn Stewart, M.D.
• Charles Craig Stieler
• Lisa G Stillwell, LCSW
• Edward Monty Stirman, M.D.
• Glenda F Stockwell, PHD
• Tina Stokely

• Family Nurse Practitioner in Kingsport, TN
• Providers in Kingsport, 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 Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.