Individual provider Active NPI

Stephanie M Childress, FNP-C

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1548737935
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
25106 Issued in TN
Practice address
316 Marketplace Blvd Ste 20
Johnson City, TN 37604-2596
Phone
(423) 794-5580
NPI assigned
Oct 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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 25106 TN Primary

Addresses

Primary practice location

316 Marketplace Blvd Ste 20
Johnson City, TN 37604-2596

Mailing address

101 Med Tech Pkwy Ste 200
Johnson City, TN 37604-4001
Phone (423) 794-5520

Other practice location 1

301 Med Tech Pkwy Ste 240
Johnson City, TN 37604-2641
Phone (423) 794-5520

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
I20190828004238 TN Practitioner - Nurse Practitioner 2365770328 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
State of Franklin Healthcare Associates, PLLCGroup PAC ID 2466346291, 258 clinicians
Champion Physical Therapy LLC HallsGroup PAC ID 1355416306, shared by 4 NPIs, 277 clinicians

Practice addresses (Care Compare)

301 Med Tech Pkwy
Johnson City, TN 37604-2364
Phone (423) 794-5500

316 Marketplace Blvd
Suite 20
Johnson City, TN 37604-2596
Phone 42323261201249

420 Railroad St
Elizabethton, TN 37643-2504
Phone (423) 297-1813

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25106TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Franklin Healthcare Associates PLLC CurrentSince Mar 1, 2020 Accepting new patients
Specialists in Pain Management, PLLC Dba Spine & Pain Associates CurrentSince Jan 1, 2026 Accepting new patients
Specialists in Pain Management, PLLC Dba Spine & Pain Associates CurrentSince Jan 1, 2026 Accepting new patients
Southeastern Physician Services PC CurrentSince Jul 1, 2019 Accepting new patients

Locations

281 N Lyerly St
Ste 200
Chattanooga, TN 37404
Phone (423) 698-0850

215 E Springbrook Dr
Johnson City, TN 37601
Phone (423) 530-7900

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

313 Princeton Rd
Ste 3
Johnson City, TN 37601
Phone (423) 282-4819

101 Med Tech Pkwy
Ste 200
Johnson City, TN 37604
Phone (423) 232-6120

316 Marketplace Blvd
Ste 20
Johnson City, TN 37604
Phone (423) 794-5500

301 Med Tech Pkwy
Ste 240
Johnson City, TN 37604
Phone (423) 794-5520

301 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 302-6239

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4
  • Direct secure messaging: stephaniechildress@sofha.allscriptsdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1548737935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MED TECH PKWY STE 200",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044001",
            "telephone_number": "423-794-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 MARKETPLACE BLVD STE 20",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042596",
            "telephone_number": "423-794-5580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Med Tech Pkwy Ste 240",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042641",
            "country_code": "US",
            "telephone_number": "423-794-5520",
            "fax_number": "423-282-6940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHILDRESS",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "25106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.