Raven Michelle Heatherly, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

23818 Issued in TN

Practice address

90 Vermont Ave Ste 300
Oak Ridge, TN 37830

Phone

(865) 481-2541

Fax

(865) 483-8151

NPI assigned

Feb 7, 2018

Last updated

Aug 8, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Lincoln Memorial University Medical Department, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Knoxville Hma Physician Management, LLCGroup PAC ID 6103097316, 118 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Physicians Regional Medical Center Hospital, Powell, TN, CCN 440120

Merit-based Incentive Payment System (MIPS)

Final score

88.07 of 100Reported as apm

Quality

73.89

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/4694/brand/1/csg/1/fhir/r4
• Direct secure messaging: raven.heatherly.1@4694.direct.athenahealth.com
• Direct secure messaging: raven.heatherly.p1@direct.orthotn.nextgenshare.com

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.

• Knoxville Hma Physician Management, LLC

  • Pulmonary Disease Physician
  • Knoxville, TN
  • NPI 1629356969

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  Medicare reassignment NPD
• Eastlake Medical, PLLC

  dba Eastlake Urgent Care

  • Rural Health Clinic/Center
  • La Follette, TN
  • NPI 1467992446
  NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Orthotennessee, PC

  dba Koc

  • Orthopaedic Surgery Physician
  • Knoxville, TN
  • NPI 1053402040
  NPD (past)

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

• Metro Knoxville Hma LLC

  dba Tennova Healthcare North Knoxville Medical Center

  • General Acute Care Hospital
  • Powell, TN
  • NPI 1043292899
  Care Compare affiliation

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1417456203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 FORT SANDERS WEST BLVD STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223355",
            "telephone_number": "865-769-4500",
            "fax_number": "865-769-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 VERMONT AVE STE 300",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "37830",
            "telephone_number": "865-481-2541",
            "fax_number": "865-483-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATHERLY",
        "first_name": "RAVEN",
        "middle_name": "MICHELLE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-07",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "23818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Lorraine Haynes
• Haley Renae Hazel
• Sydney Joline Heacock
• David Grant Heald, M.D.
• Amie Nicole Healy
• Gabrielle Heatwole, LPN
• Keith Heifner, LPC
• Dewanna Henderson, PA-C, BA
• Michael A Henderson, MD
• Sarah Elizabeth Hendrix, PA-C, MMS

• Nurse Practitioner in Oak Ridge, TN
• Providers in Oak Ridge, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.