Individual provider Active NPI

Kelly Tabor, FNP-C

  • Family Nurse Practitioner
  • Hendersonville, TN
National Provider Identifier
1467903872
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21839 Issued in TN
Practice address
102 Wessington PL
Hendersonville, TN 37075-3085
Phone
(615) 418-2916
NPI assigned
Oct 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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 21839 TN Primary

Addresses

Primary practice location

102 Wessington PL
Hendersonville, TN 37075-3085

Mailing address

3024 Business Park Cir
Goodlettsville, TN 37072-3132
Phone (615) 239-2018

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
I20181010003887 TN Practitioner - Nurse Practitioner 9133471618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Diagnostic Imaging PCGroup PAC ID 7315848140, 523 clinicians

Practice addresses (Care Compare)

3024 Business Park Cir
Goodlettsville, TN 37072-3132
Phone (615) 851-6033

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21839TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Diagnostic Imaging, PC CurrentSince Oct 18, 2019 Accepting new patients
Advanced Diagnostic Imaging PC CurrentSince Oct 18, 2019 Accepting new patients

Locations

300 Steam Plant Rd
Fl 3
Gallatin, TN 37066
Phone (615) 822-2214

300 Steam Plant Rd
Fl POD3
Gallatin, TN 37066

3024 Business Park Cir
Goodlettsvlle, TN 37072
Phone (615) 239-2018

102 Wessington Pl
#A
Hendersonville, TN 37075
Phone (615) 822-2214

102 Wessington Pl
Hendersonvlle, TN 37075
Phone (615) 418-2916

3443 Dickerson Pike
Ste 400
Nashville, TN 37207
Phone (615) 612-2146

Interoperability endpoints

  • Direct secure messaging: kelly.tabor@ahp.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1467903872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 BUSINESS PARK CIR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723132",
            "telephone_number": "615-239-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WESSINGTON PL",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370753085",
            "telephone_number": "615-418-2916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABOR",
        "first_name": "KELLY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-20",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

Verify at the official NPI Registry.