Individual provider Active NPI

Blair McCloud, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1457138596
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
34732 Issued in TN
Practice address
109 W Watauga Ave
Johnson City, TN 37604-5668
Phone
(423) 232-2600
NPI assigned
Sep 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 34732 TN Primary

Addresses

Primary practice location

109 W Watauga Ave
Johnson City, TN 37604-5668

Mailing address

1167 Spratlin Park Dr
Gray, TN 37615-6205
Phone (423) 467-3600

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
I20231004000627 TN Practitioner - Nurse Practitioner 6507210978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Frontier HealthGroup PAC ID 2860302320, 70 clinicians

Practice addresses (Care Compare)

426 E G St
Elizabethton, TN 37643-3224
Phone (423) 467-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34732TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Frontier Health CurrentSince Sep 21, 2023 Accepting new patients
Frontier Health CurrentSince Sep 21, 2023 Accepting new patients
Frontier Health Past Accepting new patients
Frontier Health Past Accepting new patients

Locations

1145 Volunteer Pkwy
Bristol, TN 37620
Phone (423) 989-4500

426 E G St
Elizabethton, TN 37643
Phone (423) 547-5950

218 N Main Ave
Erwin, TN 37650
Phone (423) 741-8263

401 Holston Dr
Greeneville, TN 37743
Phone (423) 639-1104

109 W Watauga Ave
Johnson City, TN 37604
Phone (423) 232-2600

1167 Spratlin Park Dr
Johnson City, TN 37615
Phone (423) 232-2670

1570 Waverly Rd
Kingsport, TN 37664
Phone (423) 224-1300

318 Donnelly St
Mountain City, TN 37683
Phone (423) 727-2100

101 Lena Dr
Rogersville, TN 37857
Phone (423) 272-9239

210 River Rd
Sneedville, TN 37869
Phone (423) 733-2061

Organizations & group practices 4

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": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1457138596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 SPRATLIN PARK DR",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376156205",
            "telephone_number": "423-467-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W WATAUGA AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045668",
            "telephone_number": "423-232-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLOUD",
        "first_name": "BLAIR",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-12",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "34732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.