Individual provider Active NPI

Bonnie L Messerschmidt, NP

  • Nurse Practitioner
  • Kingsport, TN
National Provider Identifier
1619935210
Registry record updated Sep 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6704 Issued in TN
Practice address
2995 Fort Henry Dr
Suite 100
Kingsport, TN 37664-4005
Phone
(423) 246-6445
Fax
(423) 246-8240
NPI assigned
May 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 6704 TN Primary

Addresses

Primary practice location

2995 Fort Henry Dr
Suite 100
Kingsport, TN 37664-4005

Mailing address

2995 Fort Henry Dr
Suite 100
Kingsport, TN 37664-4005
Phone (423) 246-6445

Other identifiers 2

IdentifierTypeStateIssuer
TN0103OtherTNJOHN DEER HEALTH
3908262MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6704TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Allergy & Asthma Center, PC PastSince Jan 1, 2006 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380326400000",
    "number": "1619935210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 FORT HENRY DR",
            "address_2": "SUITE 100",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376644005",
            "telephone_number": "423-246-6445",
            "fax_number": "423-246-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2995 FORT HENRY DR",
            "address_2": "SUITE 100",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376644005",
            "telephone_number": "423-246-6445",
            "fax_number": "423-246-8240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESSERSCHMIDT",
        "first_name": "BONNIE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2013-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "6704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEER HEALTH",
            "identifier": "TN0103",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3908262",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.