Kaitlyn Ruthann Blankenbeckler, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

32782 Issued in TN

Practice address

416 Rolling Dr
Kingsport, TN 37660-6767

Phone

(423) 502-3072

NPI assigned

Dec 14, 2022

Last updated

Dec 14, 2022By the provider in NPPES

Sex

Female

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017
• Lonesome Pine Hospital Hospital, Big Stone Gap, VA, CCN 490114
• Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
• Indian Path Community Hospital Hospital, Kingsport, TN, CCN 440176
• Lee County Community Hospital Hospital, Pennington Gap, VA, CCN 491309

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mountain States Health Alliance

  dba Indian Path Community Hospital

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1992813240
  Care Compare affiliation
• Wellmont Health System

  dba Bristol Regional Medical Center

  • General Acute Care Hospital
  • Bristol, TN
  • NPI 1124058615
  Care Compare affiliation
• Wellmont Health System

  dba Holston Valley Medical Center

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1487690400
  Care Compare affiliation
• Mountain States Health Alliance

  dba Lee County Community Hospital

  • Critical Access Hospital
  • Pennington Gap, VA
  • NPI 1205488996
  Care Compare affiliation
• Wellmont Health System

  dba Lonesome Pine Hospital

  • General Acute Care Hospital
  • Big Stone Gap, VA
  • NPI 1801826912
  Care Compare affiliation

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1295447910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 ROLLING DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376606767",
            "telephone_number": "423-502-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 ROLLING DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376606767",
            "telephone_number": "423-502-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENBECKLER",
        "first_name": "KAITLYN",
        "middle_name": "RUTHANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "32782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin K Blake, NP
• Casey Jean Blakley, RPH
• Racheal Amanda Blakley, M.S OTR/L
• Kerri Elyse Blancarte, LPC
• Susan Montella Bland, M.D.
• Courtney Lahatte Blankenship, DMD
• Myra Davis Blankenship, MSN, FNP-BC
• John Kent Blazier, MD
• BLC Wellington - Colonial Heights, LLC (Brookdale Colonial Heights)
• Tony Bleckley, PT

• 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 Dec 14, 2022; 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.
• 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.