Kristy Borum, NURSE PRACTITIONER

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

21720 Issued in TN

Practice address

975 E 3Rd St
Chattanooga, TN 37403-2147

Phone

(423) 778-7000

NPI assigned

Jan 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kristy Borum Other name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Medical Education Assistance Corporation

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1235180480
  Medicare reassignment
• Medical Genetics Lab

  • Clinical Medical Laboratory
  • Mountain Home, TN
  • NPI 1023229713
  NPD (past)

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

{
    "created_epoch": "1548374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1659835429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032147",
            "telephone_number": "423-778-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 N. State of Franklin Road",
            "address_2": "Ground Floor",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "37604",
            "country_code": "US",
            "telephone_number": "423-439-7320",
            "fax_number": "423-439-7373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORUM",
        "first_name": "KRISTY",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-25",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TN",
            "license": "21720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q046666",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTY",
            "last_name": "BORUM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amy Dawn Boren, NP-C
• Todd Patrick Boren, M.D.
• Anna Borneman
• Ashlei Boron
• Eileen Y Boroughs, MD
• Gustavo Jose Boscan Pinto, FNP
• Gracelyn Cheruba Bose, MD, MBA
• Brittany Baxter Bossert, FNP-C
• Frederick Robert Bossert, MD
• Charles Robert Bosshardt, MD

• Neonatal Nurse Practitioner in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Neonatal Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.