Individual provider Active NPI

Mary Gehring Hayes, FNP

  • Nurse Practitioner
  • Pennington Gap, VA
National Provider Identifier
1295964179
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
17856 Issued in TN
Practice address
1800 Combs Rd
Pennington Gap, VA 24277-1808
Phone
(276) 546-1440
NPI assigned
Jul 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0001117056 VA
Nurse Practitioner 363L00000X 17856 TN Primary

Addresses

Primary practice location

1800 Combs Rd
Pennington Gap, VA 24277-1808

Mailing address

1431 Centerpoint Blvd
Suite 100
Knoxville, TN 37932-1984
Phone (865) 985-7234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090914000622 VA Practitioner - Nurse Practitioner 1456407626 Reassigns benefits to 1 organization
I20131017000721 TN Practitioner - Nurse Practitioner 1456407626

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17856TNMDNurse Practitioner
0001117056VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates Inc Current Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Feb 3, 2016 Accepting new patients
Wellmont Medical Associates Inc Nurse Practitioner CurrentSince Dec 9, 2013 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Dec 9, 2013 Accepting new patients
Emergency Coverage Services, PC Nurse Practitioner Past Accepting new patients

Locations

401 Takoma Ave
Greeneville, TN 37743
Phone (423) 639-3151

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

391 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-4406

1990 Holton Ave E
Big Stone Gap, VA 24219
Phone (276) 523-3111

Organizations & group practices 5

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": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1295964179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 CENTERPOINT BLVD",
            "address_2": "SUITE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321984",
            "telephone_number": "865-985-7234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 COMBS RD",
            "city": "PENNINGTON GAP",
            "state": "VA",
            "postal_code": "242771808",
            "telephone_number": "276-546-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "MARY",
        "middle_name": "GEHRING",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-13",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0001117056",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "17856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennington Gap, VA

Sources for this page

Verify at the official NPI Registry.