Individual provider Active NPI

Beverly Ann Mahler, FNP-C

  • Family Nurse Practitioner
  • Greeneville, TN
National Provider Identifier
1639637812
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
25528 Issued in TN
Practice address
125 Hopeville Ave
Greeneville, TN 37745-6312
Phone
(423) 470-5446
NPI assigned
Mar 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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 25528 TN Primary

Addresses

Primary practice location

125 Hopeville Ave
Greeneville, TN 37745-6312

Mailing address

125 Hopeville Ave
Greeneville, TN 37745-6312
Phone (423) 470-5446

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
I20191010002187 TN Practitioner - Nurse Practitioner 7416288113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
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)

1797 Fort Henry Dr
Kingsport, TN 37664-3226
Phone (423) 830-0516

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25528TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince May 23, 2023 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince May 23, 2023 Accepting new patients

Locations

1112 N Main Ave
Erwin, TN 37650
Phone (423) 560-6010

3430 E Andrew Johnson Hwy
Greeneville, TN 37745
Phone (423) 820-0033

1797 Fort Henry Dr
Kingsport, TN 37664
Phone (423) 830-0516

2280 S Shady St
Mountain City, TN 37683
Phone (423) 501-2165

Organizations & group practices 2

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": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1639637812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 HOPEVILLE AVE",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377456312",
            "telephone_number": "423-470-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 HOPEVILLE AVE",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377456312",
            "telephone_number": "423-470-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHLER",
        "first_name": "BEVERLY",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "25528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeneville, TN

Sources for this page

Verify at the official NPI Registry.