Kerri A Ervin, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

17394 Issued in TN

Practice address

211 Church St
Tiptonville, TN 38079-1109

Phone

(731) 623-5053

Fax

(731) 623-5054

NPI assigned

Feb 27, 2013

Last updated

Dec 5, 2019By 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

Other, 2012

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)

Hospital & facility affiliations

• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
• Baptist Memorial Hospital Union City Hospital, Union City, TN, CCN 440130
• Dyersburg Regional Medical Center Hospital, Dyersburg, TN, CCN 440072

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: kerri.ervinfnp.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
• Main Street Family Care PLLC

  • Rural Health Clinic/Center
  • Tiptonville, TN
  • NPI 1770012676
  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)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Memorial Hospital- Union City Inc

  • General Acute Care Hospital
  • Union City, TN
  • NPI 1114981768
  Care Compare affiliation
• Dyersburg Health

  dba Dyersburg Employee Pharmacy

  • Community/Retail Pharmacy
  • Dyersburg, TN
  • NPI 1043282338

  Hospital

  Care Compare affiliation
• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428
  Care Compare affiliation

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1689914632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 CHURCH ST",
            "city": "TIPTONVILLE",
            "state": "TN",
            "postal_code": "380791109",
            "telephone_number": "731-623-5053",
            "fax_number": "731-623-5054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 CHURCH ST",
            "city": "TIPTONVILLE",
            "state": "TN",
            "postal_code": "380791109",
            "telephone_number": "731-623-5053",
            "fax_number": "731-623-5054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 Carl Perkins Pkwy",
            "address_purpose": "LOCATION",
            "city": "Tiptonville",
            "state": "TN",
            "postal_code": "380791678",
            "country_code": "US",
            "telephone_number": "731-253-6690",
            "fax_number": "731-253-6692",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERVIN",
        "first_name": "KERRI",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-27",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "17394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cinderella Wigs & Breast Prosthetics
• Citizens of Lake County for Health Care Inc (Lake County Primary Care)
• Amanda Collins, PA-C
• County of Lake (Lake County Emergency Medical Service)
• Kristen Deaton, PMHNP-BC
• Courtney Faught, APN
• Colton Edward Gramse, DNP, APRN, PMHNP-BC
• Carol Winfred Guess, M.D.
• Norma Jean Johnson, BOC ABC
• Courtney Kent, PMHNP

• Family Nurse Practitioner in Tiptonville, TN
• Providers in Tiptonville, 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 Dec 5, 2019; 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.