Individual provider Active NPI

Bailey Boyd, FNP

  • Family Nurse Practitioner
  • Clinton, TN
National Provider Identifier
1417575788
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000029920 Issued in TN
Practice address
350 S Charles G Seivers Blvd
Clinton, TN 37716-3929
Phone
(865) 290-2313
NPI assigned
Jul 13, 2020
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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 APN0000029920 TN Primary

Addresses

Primary practice location

350 S Charles G Seivers Blvd
Clinton, TN 37716-3929

Mailing address

129 Meadowood Cir
La Follette, TN 37766-4540
Phone (423) 494-9803

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
I20211229000037 TN Practitioner - Nurse Practitioner 5698166718 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APN0000029920TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Aug 10, 2023 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Aug 10, 2023 Accepting new patients
Eastlake Medical, PLLC CurrentSince Sep 27, 2021 Accepting new patients

Locations

350 S Charles G Seivers Blvd
Clinton, TN 37716
Phone (865) 290-2313

2205 Jacksboro Pike
La Follette, TN 37766
Phone (423) 352-6500

2205 Jacksboro Pike
Ste 6
La Follette, TN 37766
Phone (423) 352-6500

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, 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": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1417575788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 MEADOWOOD CIR",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377664540",
            "telephone_number": "423-494-9803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S CHARLES G SEIVERS BLVD",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377163929",
            "telephone_number": "865-290-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "BAILEY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000029920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, TN

Sources for this page

Verify at the official NPI Registry.