Katelyn Marcel Buckner

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

24173 Issued in TN

Practice address

130 W Ravine Rd
Kingsport, TN 37660

Phone

(423) 224-5550

NPI assigned

May 24, 2018

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

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brookwell Health LLCGroup PAC ID 4981033032, 14 clinicians

Champion Physical Therapy LLC HallsGroup PAC ID 1355416306, 277 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katelyn.buckner@3616.securemail.prognocis.com

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.

• Brookwell Health LLC

  • Nurse Practitioner
  • Morristown, TN
  • NPI 1366072159

  TN

  Medicare reassignment Care Compare group NPD
• Apple Healthcare Group, PC

  • Physical Medicine & Rehabilitation Physician
  • Knoxville, TN
  • NPI 1396939799

  TN

  Medicare reassignment NPD
• Champion Physical Therapy LLC Halls

  • Rehabilitation Clinic/Center
  • Morristown, TN
  • NPI 1013404409
  Care Compare group
• Champion Physical Therapy LLC Halls

  • Rehabilitation Clinic/Center
  • Knoxville, TN
  • NPI 1073771564
  Care Compare group
• Champion Physical Therapy LLC Halls

  • Rehabilitation Clinic/Center
  • Johnson City, TN
  • NPI 1083101448
  Care Compare group
• Champion Physical Therapy LLC Halls

  • Rehabilitation Clinic/Center
  • Athens, TN
  • NPI 1558858902
  Care Compare group
• Apple Healthcare Group

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1497050033
  NPD
• Brookwell Health LLC

  • Family Nurse Practitioner
  • Lexington, KY
  • NPI 1538889811

  Family

  NPD (past)

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1477044527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 CAIN DR",
            "city": "BLOUNTVILLE",
            "state": "TN",
            "postal_code": "376174822",
            "telephone_number": "423-330-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37660",
            "telephone_number": "423-224-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "KATELYN",
        "middle_name": "MARCEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "24173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Wyche Bryan, D.D.S.
• Bsbymf. LLC
• Gwendolyn Lisa Buchanan, PHD
• Mark D. Buchanan, D.D.S.
• James Kyle Buck III, MD
• Dawnna E Burchett, PHARMD
• Robert Spencer Burger, BS
• Amanda Hayes Burk
• Jordan Burke, PA
• Trisha Gail Burke

• All providers in Kingsport, TN
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; 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.