Individual provider Active NPI

Amber Lynette Vance, FNP-BC

  • Family Nurse Practitioner
  • Gray, TN
National Provider Identifier
1558074328
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
32870 Issued in TN
Practice address
2103 Forest Dr Ste 5
Gray, TN 37615-8423
Phone
(423) 794-3142
Fax
(423) 794-3184
NPI assigned
Dec 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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 32870 TN Primary

Addresses

Primary practice location

2103 Forest Dr Ste 5
Gray, TN 37615-8423

Mailing address

1326 Papermill Pointe Way
Knoxville, TN 37909-1903
Phone (865) 330-6320

Other practice location 1

201 Rosewood St
Bristol, TN 37620-2566
Phone (423) 398-8884

Other practice location 2

1342 Papermill Pointe Way
Knoxville, TN 37909-1903
Phone (865) 673-5000

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
I20230215000001 TN Practitioner - Nurse Practitioner 8123490406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-Cities Gastroenterology LLCGroup PAC ID 1658354865, 4 clinicians

Practice addresses (Care Compare)

10461 Wallace Alley St
Kingsport, TN 37663-3936
Phone (423) 279-1400

Hospital & facility affiliations

  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Gastroenterology LLC CurrentSince Oct 9, 2023 Accepting new patients

Locations

1500 W Elk Ave
Ste 103
Elizabethton, TN 37643
Phone (423) 542-6055

105 Gay St
Erwin, TN 37650
Phone (423) 279-1400

1001 Tusculum Blvd
Greeneville, TN 37745
Phone (423) 972-4770

555 Justis Dr
Greeneville, TN 37745
Phone (423) 783-7965

2333 Knob Creek Rd
Ste 15
Johnson City, TN 37604

10461 Wallace Alley St
Kingsport, TN 37663
Phone (423) 279-1400

Organizations & group practices 1

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": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1558074328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 PAPERMILL POINTE WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091903",
            "telephone_number": "865-330-6320",
            "fax_number": "865-243-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 FOREST DR STE 5",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376158423",
            "telephone_number": "423-794-3142",
            "fax_number": "423-794-3184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Rosewood St",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376202566",
            "country_code": "US",
            "telephone_number": "423-398-8884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1342 Papermill Pointe Way",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379091903",
            "country_code": "US",
            "telephone_number": "865-673-5000",
            "fax_number": "865-588-5711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANCE",
        "first_name": "AMBER",
        "middle_name": "LYNETTE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-27",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "32870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gray, TN

Sources for this page

Verify at the official NPI Registry.