Individual provider Active NPI

Savannah Rasnic Bledsoe

  • Psychiatric/Mental Health Nurse Practitioner
  • Kingsport, TN
National Provider Identifier
1699403022
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
32084 Issued in TN
Practice address
1025 Executive Park Blvd
Kingsport, TN 37660-4620
Phone
(423) 830-8110
NPI assigned
Aug 12, 2022
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 32084 TN Primary

Addresses

Primary practice location

1025 Executive Park Blvd
Kingsport, TN 37660-4620

Mailing address

1025 Executive Park Blvd
Kingsport, TN 37660-4620
Phone (423) 830-8110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230921001687 TN Practitioner - Nurse Practitioner 4688028871 Reassigns benefits to 2 organizations
I20240516003465 IA Practitioner - Nurse Practitioner 4688028871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SBH-KingsportGroup PAC ID 8325399256, 10 clinicians
SBH-Davenport LLCGroup PAC ID 1759702756, 11 clinicians

Practice addresses (Care Compare)

1025 Executive Park Blvd
Kingsport, TN 37660-4620
Phone (423) 830-8110

770 Tanglefoot LN
Bettendorf, IA 52722-1608
Phone (563) 396-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SBH-Davenport, LLC CurrentSince Apr 24, 2024 Accepting new patients
SBH-Kingsport CurrentSince Jul 18, 2023 Accepting new patients
Inner Harmony Psychiatry Psychiatric/Mental Health Current Accepting new patients
SBH-Kingsport CurrentSince Jul 18, 2023 Accepting new patients
SBH-Davenport, LLC CurrentSince Apr 24, 2024 Accepting new patients
Medpsych Inc. PC CurrentSince Apr 24, 2024 Accepting new patients

Locations

770 Tanglefoot Ln
Bettendorf, IA 52722
Phone (563) 241-7443

1025 Executive Park Blvd
Kingsport, TN 37660
Phone (423) 765-0777

1905 American Way
Ste 1002
Kingsport, TN 37660
Phone (423) 830-8110

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1699403022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 EXECUTIVE PARK BLVD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604620",
            "telephone_number": "423-830-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 EXECUTIVE PARK BLVD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604620",
            "telephone_number": "423-830-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEDSOE",
        "first_name": "SAVANNAH",
        "middle_name": "RASNIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "32084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.