Patricia Annette Waddell, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

13234 Issued in TN

Practice address

657 E Broadway Blvd
Suite C
Jefferson City, TN 37760-4948

Phone

(865) 475-9062

Fax

(423) 475-9063

NPI assigned

Mar 24, 2008

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

Electronic endpoints 1

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

Locations

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.

• Healthstar Physicians, P.C.

  • Family Medicine Physician
  • Morristown, TN
  • NPI 1184610248
  Medicare reassignment NPD
• Healthstar Physicians PC

  • Pain Medicine (Anesthesiology) Physician
  • Morristown, TN
  • NPI 1841187648
  NPD
• East Tennessee Primary Care Associates

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1134271745
  NPD (past)

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1689846271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 E BROADWAY BLVD",
            "address_2": "SUITE C",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377604948",
            "telephone_number": "865-475-9062",
            "fax_number": "865-475-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 E BROADWAY BLVD",
            "address_2": "SUITE C",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377604948",
            "telephone_number": "865-475-9062",
            "fax_number": "423-475-9063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "PATRICIA",
        "middle_name": "ANNETTE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-24",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "13234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3341753",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "p.waddell.1@3525.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "657 E Broadway Blvd",
            "address_2": "Suite C",
            "city": "Jefferson City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377604948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Unity Medical Group PLLC
• University Health System, Inc
• Michael Todd Vanbruggen, ATC
• Ricky Varney, LPC-MHSP
• Albert Russell Vaughn, MD
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Hanna Walker, MS, CCC-SLP
• Nancy Carol-Samsel Walker, FNP-BC

• Family Nurse Practitioner in Jefferson City, TN
• Providers in Jefferson City, 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 Jan 21, 2022; 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.