Individual provider Active NPI

Christie Madge King-Patterson, NP-C

  • Family Nurse Practitioner
  • Waverly, TN
National Provider Identifier
1477703155
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13621 Issued in TN
Practice address
215B Holly Lane
Waverly, TN 37185
Phone
(931) 296-9969
Fax
(931) 296-8100
NPI assigned
Sep 30, 2008
Last updated
Jan 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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 13621 TN Primary

Addresses

Primary practice location

215B Holly Lane
Waverly, TN 37185

Mailing address

127 Crestview Park Dr Ste 209
Dickson, TN 37055-2856
Phone (615) 446-5121

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
I20091001000278 TN Practitioner - Nurse Practitioner 6204972417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dickson Medical Associates, PCGroup PAC ID 3971408774, 55 clinicians
King Family Medical PLLCGroup PAC ID 5395881510, 2 clinicians

Practice addresses (Care Compare)

215 B Holly LN
Waverly, TN 37185-3387
Phone (931) 296-9969

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13621TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dickson Medical Associates PC CurrentSince Apr 1, 2020 Accepting new patients
Dickson Medical Associates, PC CurrentSince Apr 1, 2020 Accepting new patients

Locations

127 Crestview Park Dr
Dickson, TN 37055
Phone (615) 441-4478

127 Crestview Park Dr
Ste 209
Dickson, TN 37055

215B Holly Ln
Waverly, TN 37185
Phone (931) 296-9969

300 S Clydeton Rd
Waverly, TN 37185
Phone (615) 446-5121

Interoperability endpoints

  • Direct secure messaging: ckingpatterson26927@dicksonmedicalassociates.gardenplot.direct-ci.com

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.

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": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1477703155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CRESTVIEW PARK DR STE 209",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552856",
            "telephone_number": "615-446-5121",
            "fax_number": "615-446-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215B HOLLY LANE",
            "city": "WAVERLY",
            "state": "TN",
            "postal_code": "37185",
            "telephone_number": "931-296-9969",
            "fax_number": "931-296-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING-PATTERSON",
        "first_name": "CHRISTIE",
        "middle_name": "MADGE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-30",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "13621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, TN

Sources for this page

Verify at the official NPI Registry.