Individual provider Active NPI

Cheryl Lynn Racine, APN, FNP

  • Family Nurse Practitioner
  • Maryville, TN
National Provider Identifier
1407115108
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN-16462 Issued in TN
Practice address
1580 Mint Meadows Drive
Maryville, TN 37803-2542
Phone
(865) 384-5166
Fax
(865) 380-4095
NPI assigned
May 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 16462 TN
Family Nurse Practitioner 363LF0000X APN-16462 TN Primary

Addresses

Primary practice location

1580 Mint Meadows Drive
Maryville, TN 37803-2542

Mailing address

1580 Mint Meadows Drive
Maryville, TN 37803-2542
Phone (865) 384-5166

Other identifiers 1

IdentifierTypeStateIssuer
Q000287MedicaidTN

Other names 1

  • Miss Cheryl Lynn Howell 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
I20120705000143 TN Practitioner - Nurse Practitioner 4688839251 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN-16462TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blount Memorial Physician Group, Inc CurrentSince Apr 6, 2015 Accepting new patients
DX Mso, PLLC CurrentSince Mar 3, 2018 Accepting new patients
Align Health Management Inc. CurrentSince Aug 17, 2021 Accepting new patients

Locations

700 E 54th St N
Sioux Falls, SD 57104
Phone (423) 458-1426

266 Joule St
Alcoa, TN 37701
Phone (865) 984-3864

1025 Peerless Xing NW
Cleveland, TN 37312
Phone (423) 476-5990

463 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5100

2732 US Highway 411 S
Maryville, TN 37801
Phone (865) 681-5277

458 Bmh Physicians Office Bldg
Maryville, TN 37804
Phone (865) 980-5355

103 W Broadway Ave
Maryville, TN 37801

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1407115108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 MINT MEADOWS DRIVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378032542",
            "telephone_number": "865-384-5166",
            "fax_number": "865-273-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 MINT MEADOWS DRIVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378032542",
            "telephone_number": "865-384-5166",
            "fax_number": "865-380-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACINE",
        "first_name": "CHERYL",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "APN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-15",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "16462",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN-16462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q000287",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "HOWELL",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "APN, FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.