Nettie Sue Hurst, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0000005051 Issued in TN

Practice address

130 N Main St
Ridgely, TN 38080-1317

Phone

(731) 264-5518

Fax

(731) 264-9859

NPI assigned

Aug 28, 2005

Last updated

Aug 11, 2014By the provider in NPPES

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

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

Specialty

Nurse Practitioner

Education

Vanderbilt University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Citizens of Lake County for Health Care IncGroup PAC ID 6507052073, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: nettie.hurst.p1@direct.clchc.nextgenshare.com

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.

• Citizens of Lake County for Health Care Inc

  dba Lake County Primary Care

  • Federally Qualified Health Center (FQHC)
  • Tiptonville, TN
  • NPI 1841311529
  Medicare reassignment Care Compare group NPD
• Citizens of Lake County for Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Troy, TN
  • NPI 1619593944
  NPD
• Citizens of Lake County for Health Care, Inc

  dba Lauderdale County Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Ripley, TN
  • NPI 1558609628
  NPD (past)
• Rural Health Clinics of West TN PLLC

  • Legal Medicine
  • Ripley, TN
  • NPI 1104864370
  NPD (past)

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

{
    "created_epoch": "1125187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1689667305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 N MAIN ST",
            "city": "RIDGELY",
            "state": "TN",
            "postal_code": "380801317",
            "telephone_number": "731-264-5518",
            "fax_number": "731-264-9859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N MAIN ST",
            "city": "RIDGELY",
            "state": "TN",
            "postal_code": "380801317",
            "telephone_number": "731-264-5518",
            "fax_number": "731-264-9859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURST",
        "first_name": "NETTIE",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-28",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "0000005051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Citizens of Lake County for Health Care Inc (William B, Acree Clinic)
• Anna Davis, APRN
• HQM of Ridgely, LLC (Ridgely Care & Rehabilitation Center)
• LP Ridgely LLC (Signature HealthCARE of Ridgely Rehab & Wellness Center)
• Darin O'Shea Stites II, PA-C
• Taylor Bros Pharmacy LLC

• Family Nurse Practitioner in Ridgely, TN
• Providers in Ridgely, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.