Individual provider Active NPI

Olivia McKamey

  • Family Nurse Practitioner
  • Jacksboro, TN
National Provider Identifier
1568031169
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
29718 Issued in TN
Practice address
2702 Jacksboro Pike
Jacksboro, TN 37757-4850
Phone
(423) 201-9937
NPI assigned
Jun 18, 2021
Last updated
Nov 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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 29718 TN Primary

Addresses

Primary practice location

2702 Jacksboro Pike
Jacksboro, TN 37757-4850

Mailing address

223 Storm LN
Jacksboro, TN 37757-2151

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
I20210811000853 TN Practitioner - Nurse Practitioner 7810391943 Reassigns benefits to 3 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
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

100 E Tennessee St
Collinwood, TN 38450
Phone (931) 724-9000

4696 Nashville Hwy
Chapel Hill, TN 37034-2110
Phone (931) 364-5321

514 N Main St
Rocky Top, TN 37769-2818
Phone (865) 205-9582

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29718TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Velocity Medical LLC CurrentSince Sep 1, 2021 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince May 30, 2021 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince May 30, 2021 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients

Locations

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

120 Tanner Pl
Clinton, TN 37716
Phone (865) 264-4012

2702 Jacksboro Pike
Jacksboro, TN 37757
Phone (423) 201-9937

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.

NPI Registry JSON

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1568031169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 STORM LN",
            "city": "JACKSBORO",
            "state": "TN",
            "postal_code": "377572151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 JACKSBORO PIKE",
            "city": "JACKSBORO",
            "state": "TN",
            "postal_code": "377574850",
            "telephone_number": "423-201-9937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKAMEY",
        "first_name": "OLIVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "29718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksboro, TN

Sources for this page

Verify at the official NPI Registry.