Individual provider Active NPI

Casey Renee Kepner, FNP

  • Family Nurse Practitioner
  • Cleveland, TN
National Provider Identifier
1598073561
Registry record updated Sep 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15229 Issued in TN
Practice address
4021 Keith St NW
Cleveland, TN 37312-4341
Phone
(423) 476-2464
Fax
(423) 476-1008
NPI assigned
Sep 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2010

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 15229 TN Primary

Addresses

Primary practice location

4021 Keith St NW
Cleveland, TN 37312-4341

Mailing address

4021 Keith St NW
Cleveland, TN 37312-4341
Phone (423) 476-2464

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
I20110204000265 TN Practitioner - Nurse Practitioner 6002096278 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15229TNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Hamilton County Hospital Authority CurrentSince Aug 1, 2016 Accepting new patients
Chattanooga Hamilton County Hospital Authority Current Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Aug 1, 2016 Accepting new patients

Locations

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

910 Blackford St
Chattanooga, TN 37403
Phone (423) 778-4044

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285200000000",
    "number": "1598073561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 KEITH ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124341",
            "telephone_number": "423-476-2464",
            "fax_number": "423-476-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 KEITH ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124341",
            "telephone_number": "423-476-2464",
            "fax_number": "423-476-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPNER",
        "first_name": "CASEY",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-23",
        "last_updated": "2010-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "15229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.