Individual provider Active NPI

Carla Renee Cheek, FNP

  • Family Nurse Practitioner
  • Kingsport, TN
National Provider Identifier
1275525354
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000006829 Issued in TN
Practice address
2 Sheridan SQ
Suite 200
Kingsport, TN 37660-7399
Phone
(423) 392-2887
Fax
(423) 246-8278
NPI assigned
Aug 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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 APN0000006829 TN Primary

Addresses

Primary practice location

2 Sheridan SQ
Suite 200
Kingsport, TN 37660-7399

Mailing address

2 Sheridan SQ
Suite 200
Kingsport, TN 37660-7399
Phone (423) 392-2887

Other names 1

  • Mrs. Carla Renee Hensley Former name

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
I20060214000550 TN Practitioner - Nurse Practitioner 1153336052 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN0000006829TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Neuroscience Center, P.C. CurrentSince May 5, 2003 Accepting new patients

Locations

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

2 Sheridan Sq
Ste 200
Kingsport, TN 37660
Phone (423) 224-3100

Interoperability endpoints

  • Direct secure messaging: ccheek@brncpc.gwaydirect.com

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1275525354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SHERIDAN SQ",
            "address_2": "SUITE 200",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607399",
            "telephone_number": "423-392-2887",
            "fax_number": "423-246-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SHERIDAN SQ",
            "address_2": "SUITE 200",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607399",
            "telephone_number": "423-392-2887",
            "fax_number": "423-246-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEEK",
        "first_name": "CARLA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000006829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLA",
            "last_name": "HENSLEY",
            "middle_name": "RENEE",
            "prefix": "MRS.",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.