Sandra Ella Humphrey Mincey, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

19964 Issued in TN

Practice address

McNeeley Family Physicians
110 Executive Park Drive
Clinton, TN 37716

Phone

(865) 494-9241

Fax

(865) 494-0895

NPI assigned

Jun 8, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010
  Medicare reassignment NPD
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1871269415
  NPD
• Crossville Medical Group PA

  • Multi-Specialty Clinic/Center
  • Crossville, TN
  • NPI 1053414698
  NPD (past)

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1326428087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 OLD WEISGARBER RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091291",
            "telephone_number": "865-584-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MCNEELEY FAMILY PHYSICIANS",
            "address_2": "110 EXECUTIVE PARK DRIVE",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "37716",
            "telephone_number": "865-494-9241",
            "fax_number": "865-494-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINCEY",
        "first_name": "SANDRA",
        "middle_name": "ELLA HUMPHREY",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "19964",
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "TN",
            "license": "20210308",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q015005",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mincey.sandra@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "McNeeley Family Physicians",
            "address_2": "110 Executive Park Drive",
            "city": "Clinton",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Crystal Michelle Mealer, OT
• Alma Meraz
• Krea Merritt, PTA, CCI
• Matthew A Meyers, AANP
• Jason Daniel Mikles, RN
• Kelli Denise Minga, OTA
• Casey R Moles
• Casey J Montague, H.I.S.
• Bailey A Moore, COTA
• Jessica Moore, APRN

• Family Nurse Practitioner in Clinton, TN
• Providers in Clinton, 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 24, 2020; 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.