Individual provider Active NPI

Cory Lynn Legan, FNP-C

  • Family Nurse Practitioner
  • La Follette, TN
National Provider Identifier
1336978899
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
36702 Issued in TN
Practice address
2205 Jacksboro Pike
La Follette, TN 37766-2904
Phone
(423) 352-6500
NPI assigned
Jul 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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 36702 TN Primary

Addresses

Primary practice location

2205 Jacksboro Pike
La Follette, TN 37766-2904

Mailing address

2205 Jacksboro Pike
La Follette, TN 37766-2904
Phone (423) 352-6500

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
I20241104002019 TN Practitioner - Nurse Practitioner 6305379926 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Infusions LLCGroup PAC ID 6608054044, 102 clinicians

Practice addresses (Care Compare)

318 Prosperity Dr
Knoxville, TN 37923-4710
Phone (865) 299-7525

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36702TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Infusions, LLC CurrentSince Sep 15, 2025 Accepting new patients
Innovative Infusions, LLC CurrentSince Sep 15, 2025 Accepting new patients
Eastlake Medical, PLLC CurrentSince Aug 6, 2024 Accepting new patients

Locations

318 Prosperity Dr
Knoxville, TN 37923
Phone (865) 299-7525

2205 Jacksboro Pike
Ste 6
La Follette, TN 37766
Phone (423) 352-6500

2205 Jacksboro Pike
La Follette, TN 37766
Phone (423) 352-6500

502 W Central Ave
Ste 2
La Follette, TN 37766
Phone (423) 201-9799

Organizations & group practices 4

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": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1336978899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 JACKSBORO PIKE",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377662904",
            "telephone_number": "423-352-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 JACKSBORO PIKE",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377662904",
            "telephone_number": "423-352-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGAN",
        "first_name": "CORY",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "36702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Follette, TN

Sources for this page

Verify at the official NPI Registry.