Individual provider Active NPI

Kacey Q. Voelker, MSN, FNP-BC

  • Family Nurse Practitioner
  • Morristown, TN
National Provider Identifier
1457767345
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18815 Issued in TN
Practice address
420 W Morris Blvd
Suite 400G
Morristown, TN 37813-2283
Phone
(423) 581-5925
Fax
(423) 581-2828
NPI assigned
Jul 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 182891 TN
Family Nurse Practitioner 363LF0000X 18815 TN Primary

Addresses

Primary practice location

420 W Morris Blvd
Suite 400G
Morristown, TN 37813-2283

Mailing address

420 W Morris Blvd
Suite 400G
Morristown, TN 37813-2283
Phone (423) 581-2660

Other identifiers 1

IdentifierTypeStateIssuer
Q009105MedicaidTN

Other names 1

  • Kacey Q. Roach Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kacey.roach.1@3525.direct.athenahealth.com

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
I20141110000288 TN Practitioner - Nurse Practitioner 8628290525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthstar Physicians PCGroup PAC ID 5890690978, 89 clinicians

Practice addresses (Care Compare)

420 W Morris Blvd
Morristown, TN 37813-2282

420 W Morris Blvd
Suite 400H
Morristown, TN 37813-2283
Phone (423) 586-4545

657 E Broadway Blvd
Suite a
Jefferson City, TN 37760-4949
Phone (865) 475-9062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
182891TNMDRegistered Nurse
18815TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthstar Physicians, P.C. CurrentSince Aug 18, 2014 Accepting new patients
Healthstar Physicians PC CurrentSince Aug 18, 2014 Accepting new patients
East Tennessee Primary Care Associates Past Accepting new patients

Locations

657 E Broadway Blvd
Ste C
Jefferson Cty, TN 37760
Phone (423) 586-1717

5741 W Andrew Johnson Hwy
Morristown, TN 37814
Phone (423) 585-0686

420 W Morris Blvd
Ste 400G
Morristown, TN 37813
Phone (423) 581-2538

420 W Morris Blvd
Ste 400C
Morristown, TN 37813
Phone (423) 586-0443

Interoperability endpoints

  • Direct secure messaging: kacey.roach.1@3525.direct.athenahealth.com

Organizations & group practices 8

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": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1457767345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W MORRIS BLVD",
            "address_2": "SUITE 400G",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132283",
            "telephone_number": "423-581-2660",
            "fax_number": "423-581-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W MORRIS BLVD",
            "address_2": "SUITE 400G",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132283",
            "telephone_number": "423-581-5925",
            "fax_number": "423-581-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOELKER",
        "first_name": "KACEY",
        "middle_name": "Q.",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-11",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "182891",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q009105",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kacey.roach.1@3525.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "420 W Morris Blvd",
            "address_2": "Suite 400G",
            "city": "Morristown",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378132283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KACEY",
            "last_name": "ROACH",
            "middle_name": "Q.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Morristown, TN

Sources for this page

Verify at the official NPI Registry.