Individual provider Active NPI

Katherine Ratcliff Clabo, APRN

  • Family Nurse Practitioner
  • Jefferson City, TN
National Provider Identifier
1508484775
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
30023 Issued in TN
Practice address
380 W Broadway Blvd Ste 130
Jefferson City, TN 37760-2602
Phone
(865) 475-4742
NPI assigned
Jul 13, 2020
Last updated
May 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 30023 TN Primary
Registered Nurse 163W00000X 0000230588 TN

Addresses

Primary practice location

380 W Broadway Blvd Ste 130
Jefferson City, TN 37760-2602

Mailing address

1275 Dick Lonas Rd Unit 101
Knoxville, TN 37909-1383
Phone (865) 584-4747

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
I20220201000482 TN Practitioner - Nurse Practitioner 3678966454 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

3614 W Andrew Johnson Hwy
Morristown, TN 37814-3602
Phone (423) 586-9495

380 W Broadway Blvd
Jefferson City, TN 37760-5279
Phone (865) 475-4742

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000230588TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Greenbrier Medical Family CurrentSince Nov 1, 2021 Accepting new patients
Summit Medical Group, PLLC CurrentSince Apr 19, 2024 Accepting new patients
Summit Medical Group, PLLC CurrentSince Apr 19, 2024 Accepting new patients
Summit Medical Group, PLLC Past Accepting new patients

Locations

380 W Broadway Blvd
Jefferson City, TN 37760
Phone (865) 450-9361

380 W Broadway Blvd
Ste 130
Jefferson City, TN 37760
Phone (865) 475-4742

1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627

1275 Dick Lonas Rd
Unit 101
Knoxville, TN 37909

1110 Village Dr
Sevierville, TN 37862
Phone (865) 429-8800

Interoperability endpoints

  • Direct secure messaging: katherine.clabo.1@20785.direct.athenahealth.com

Organizations & group practices 5

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 1

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": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1508484775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 DICK LONAS RD UNIT 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091383",
            "telephone_number": "865-584-4747",
            "fax_number": "865-429-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 W BROADWAY BLVD STE 130",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602602",
            "telephone_number": "865-475-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLABO",
        "first_name": "KATHERINE",
        "middle_name": "RATCLIFF",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2024-05-02",
        "certification_date": "2024-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "30023",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "0000230588",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, TN

Sources for this page

Verify at the official NPI Registry.