Individual provider Active NPI

Lillian Amber McCall, MSN, APRN, FNP-C

  • Nurse Practitioner
  • Kingsport, TN
National Provider Identifier
1386108462
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
25392 Issued in TN
Practice address
2300 W Stone Dr
Kingsport, TN 37660-2360
Phone
(423) 246-4961
NPI assigned
Jan 23, 2019
Last updated
Feb 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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 25392 TN Primary
Registered Nurse 163W00000X 209670 TN

Addresses

Primary practice location

2300 W Stone Dr
Kingsport, TN 37660-2360

Mailing address

2300 W Stone Dr
Kingsport, TN 37660-2360
Phone (423) 246-4961

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
I20190426002362 TN Practitioner - Nurse Practitioner 1850633686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Lincoln Memorial University Medical Department, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates, P.C.Group PAC ID 3971578816, 26 clinicians

Practice addresses (Care Compare)

2300 W Stone Dr
Kingsport, TN 37660-2360
Phone (423) 246-4961

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209670TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates, P.C. CurrentSince Feb 1, 2019 Accepting new patients

Locations

2885 Boones Creek Rd
Johnson City, TN 37615
Phone (423) 928-9014

2300 W Stone Dr
Kingsport, TN 37660
Phone (423) 246-4961

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1386108462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 W STONE DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376602360",
            "telephone_number": "423-246-4961",
            "fax_number": "423-245-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 W STONE DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376602360",
            "telephone_number": "423-246-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALL",
        "first_name": "LILLIAN",
        "middle_name": "AMBER",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "25392",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "209670",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.