Individual provider Active NPI

Lynda Marie Morelli, APRN

  • Family Nurse Practitioner
  • Jefferson City, TN
National Provider Identifier
1366584807
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12749 Issued in TN
Practice address
1004 N Highway 92
Suite C
Jefferson City, TN 37760-3687
Phone
(865) 475-2120
Fax
(855) 544-2120
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 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 12749 TN Primary

Addresses

Primary practice location

1004 N Highway 92
Suite C
Jefferson City, TN 37760-3687

Mailing address

7074 Mayfair St
Talbott, TN 37877-8528
Phone (865) 475-2120

Other identifiers 1

IdentifierTypeStateIssuer
12749OtherTNTN APN

Other names 1

  • Ms. Lynda Marie Mannetta 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
I20071129000303 TN Practitioner - Nurse Practitioner 7911926258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coffee County Hospital Group IncGroup PAC ID 1456317783, 87 clinicians
Ultacare Medical PLLCGroup PAC ID 4789687484, 52 clinicians

Practice addresses (Care Compare)

482 Interstate Dr
Manchester, TN 37355-3109
Phone (931) 728-4718

606 N Broad St
New Tazewell, TN 37825-6610
Phone (423) 259-5002

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ultacare Medical PLLC CurrentSince Feb 25, 2013 Accepting new patients
Coffee Medical Group LLC Past Accepting new patients

Locations

1225 E Weisgarber Rd
Ste 190
Knoxville, TN 37909
Phone (423) 259-5002

606 N Broad St
New Tazewell, TN 37825
Phone (423) 626-0466

415 Cole Dr
Pigeon Forge, TN 37863
Phone (865) 428-5454

1229 Fox Meadows Blvd
Ste 2
Sevierville, TN 37862
Phone (865) 365-4015

5261 Carrollton Pike
Ste A
Woodlawn, VA 24381

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1366584807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7074 MAYFAIR ST",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "378778528",
            "telephone_number": "865-475-2120",
            "fax_number": "855-544-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 N HIGHWAY 92",
            "address_2": "SUITE C",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377603687",
            "telephone_number": "865-475-2120",
            "fax_number": "855-544-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORELLI",
        "first_name": "LYNDA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "12749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN APN",
            "identifier": "12749",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNDA",
            "last_name": "MANNETTA",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jefferson City, TN

Sources for this page

Verify at the official NPI Registry.