Individual provider Active NPI

Tiffany L Yandell, NP

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1538408372
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
17392 Issued in TN
Practice address
119 Boone Ridge Dr
Suite 201
Johnson City, TN 37615-4998
Phone
(423) 282-1480
Fax
(423) 928-1353
NPI assigned
Feb 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0000016532 TN
Family Nurse Practitioner 363LF0000X 17392 TN Primary

Addresses

Primary practice location

119 Boone Ridge Dr
Suite 201
Johnson City, TN 37615-4998

Mailing address

119 Boone Ridge Dr
Suite 201
Johnson City, TN 37615-4998
Phone (423) 282-1480

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
I20130312000413 TN Practitioner - Nurse Practitioner 8224283551 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BH Services Southeast 1 PCGroup PAC ID 7012457054, 96 clinicians
Ipc Pac Healthcare Services of Tennessee PCGroup PAC ID 0840587572, 74 clinicians

Practice addresses (Care Compare)

18 N Cavalier Dr
Alamo, TN 38001-6468
Phone (731) 696-4500

505 N Roan St
Johnson City, TN 37601-4740
Phone (423) 975-2000

811 W Main St
Waverly, TN 37185-1449
Phone (931) 296-4131

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.72 of 100Reported as apm
Quality
72.97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0000016532TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 Southeast, LLC CurrentSince Sep 9, 2024 Accepting new patients
BH Services Southeast 1 PC CurrentSince Mar 1, 2025 Accepting new patients
Southeastern Physician Services PC CurrentSince Oct 1, 2016 Accepting new patients
BH Services Southeast 1 PC Past Accepting new patients
Professional Imaging of Tennessee Past Accepting new patients

Locations

723 Burkesville Rd
Albany, KY 42602
Phone (606) 387-6421

1004 Holiday Ln
Fulton, KY 42041
Phone (270) 472-1971

114 E McMurtry Ave
Hartford, KY 42347
Phone (270) 298-7437

18 N Cavalier Dr
Alamo, TN 38001
Phone (731) 696-4500

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Organizations & group practices 7

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 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": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1538408372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 BOONE RIDGE DR",
            "address_2": "SUITE 201",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154998",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 BOONE RIDGE DR",
            "address_2": "SUITE 201",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154998",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANDELL",
        "first_name": "TIFFANY",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-13",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "0000016532",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "17392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.