Individual provider Active NPI

Kristen Dykes, FNP

  • Family Nurse Practitioner
  • Rogersville, TN
National Provider Identifier
1487128708
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
25376 Issued in TN
Practice address
4307 Highway 66 S
Rogersville, TN 37857-3155
Phone
(423) 921-1600
Fax
(423) 921-1681
NPI assigned
Jan 21, 2019
Last updated
May 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

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 25376 TN Primary

Addresses

Primary practice location

4307 Highway 66 S
Rogersville, TN 37857-3155

Mailing address

PO Box 850
Rogersville, TN 37857-0850
Phone (423) 272-9163

Other practice location 1

1861 Main St
Sneedville, TN 37869
Phone (423) 733-2131

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
I20190722000890 TN Practitioner - Nurse Practitioner 6901132489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Lincoln Memorial University Medical Department, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4307 Hwy 68 S
Rogersville, TN 37857-3155
Phone (423) 921-1300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25376TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Health Services Consortium of Upper East Tennessee Inc CurrentSince Apr 30, 2019 Accepting new patients
Rural Health Services Consortium of Upper East Tennessee Inc CurrentSince Apr 30, 2019 Accepting new patients
Rural Health Services Consortium of Upper East Tennessee Inc Current Accepting new patients
Rural Health Services Consortium of Upper East Tennessee Inc Past Accepting new patients

Locations

4307 Highway 66 S
Rogersville, TN 37857
Phone (423) 921-1600

4966 Highway 11W
Rogersville, TN 37857
Phone (423) 272-5600

1861 Main St
Sneedville, TN 37869
Phone (423) 733-0042

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1487128708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378570850",
            "telephone_number": "423-272-9163",
            "fax_number": "423-921-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4307 HIGHWAY 66 S",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378573155",
            "telephone_number": "423-921-1600",
            "fax_number": "423-921-1681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1861 Main St",
            "address_purpose": "LOCATION",
            "city": "Sneedville",
            "state": "TN",
            "postal_code": "37869",
            "country_code": "US",
            "telephone_number": "423-733-2131",
            "fax_number": "423-733-1055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYKES",
        "first_name": "KRISTEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "25376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogersville, TN

Sources for this page

Verify at the official NPI Registry.