Individual provider Active NPI

Kennedy Nicole Parrott, PA-C

  • Physician Assistant
  • Mountain City, TN
National Provider Identifier
1376415075
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6334 Issued in TN
Practice address
222 Oak St
Mountain City, TN 37683-1526
Phone
(423) 727-6319
Fax
(423) 727-4164
NPI assigned
Sep 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6334 TN Primary

Addresses

Primary practice location

222 Oak St
Mountain City, TN 37683-1526

Mailing address

PO Box 850
Rogersville, TN 37857-0850
Phone (423) 921-6975

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
I20251105003828 TN Practitioner - Physician Assistant 7911497243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4307 Hwy 68 S
Rogersville, TN 37857-3155
Phone (423) 921-1300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6334TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Health Services Consortium of Upper East Tennessee Inc CurrentSince Oct 15, 2025 Accepting new patients
Rural Health Services Consortium of Upper East Tennessee Inc CurrentSince Oct 15, 2025 Accepting new patients
Rural Health Services Consortium of Upper East Tennessee Inc Current Accepting new patients

Locations

222 Oak St
Mountain City, TN 37683
Phone (423) 727-6319

4966 Highway 11W
Rogersville, TN 37857
Phone (423) 272-5600

Organizations & group practices 3

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": "1758499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1376415075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378570850",
            "telephone_number": "423-921-6975",
            "fax_number": "423-921-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 OAK ST",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376831526",
            "telephone_number": "423-727-6319",
            "fax_number": "423-727-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARROTT",
        "first_name": "KENNEDY",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-22",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain City, TN

Sources for this page

Verify at the official NPI Registry.