Individual provider Active NPI

Heather Renee Rose, FNP-C

  • Family Nurse Practitioner
  • Abingdon, VA
National Provider Identifier
1700616414
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024190898 Issued in VA
Practice address
16000 Johnston Memorial Dr
Abingdon, VA 24211-7664
Phone
(276) 258-1000
Fax
(276) 628-3857
NPI assigned
Aug 6, 2024
Last updated
Jan 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024190898 VA Primary
Family Nurse Practitioner 363LF0000X 36787 TN

Addresses

Primary practice location

16000 Johnston Memorial Dr
Abingdon, VA 24211-7664

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 224-4000

Other practice location 2

98 15th St NW Ste 207
Norton, VA 24273-1600
Phone (276) 439-1490

Other practice location 3

400 N State Of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111

Other practice location 4

1485 Flatwoods Rd
Coeburn, VA 24230-3738
Phone (276) 219-4378

Other practice location 5

2202 N John B Dennis Hwy Ste 110
Kingsport, TN 37660-5904
Phone (423) 578-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 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
I20241203002216 TN Practitioner - Nurse Practitioner 4486189255 Reassigns benefits to 1 organization
I20241209001594 VA Practitioner - Nurse Practitioner 4486189255 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WPS Providers IncGroup PAC ID 7719079532, 83 clinicians
Dominion Health and Fitness, IncGroup PAC ID 3274570908, 71 clinicians

Practice addresses (Care Compare)

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 224-3150

4862 Dickenson Hwy
Clintwood, VA 24228-1810

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
36787TNMDEmergency Medicine Physician
0024190898VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WPS Providers Inc CurrentSince Nov 1, 2024 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Nov 1, 2024 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Nov 1, 2024 Accepting new patients
Wellmont Medical Associates, Inc. Past Accepting new patients
St. Charles Health Council, Inc Past Accepting new patients

Locations

1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

2202 N John B Dennis Hwy
Ste 110
Kingsport, TN 37660
Phone 4235788400 ext. 88500

16000 Johnston Memorial Dr
Abingdon, VA 24211
Phone (276) 258-1000

24530 Falcon Place Blvd
Ste 100
Abingdon, VA 24211
Phone (276) 619-0075

323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612

98 15th St NW
Ste 207
Norton, VA 24273
Phone (276) 439-1295

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1700616414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 JOHNSTON MEMORIAL DR",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242117664",
            "telephone_number": "276-258-1000",
            "fax_number": "276-628-3857"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 W Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603837",
            "country_code": "US",
            "telephone_number": "423-224-4000",
            "fax_number": "423-224-3169",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "98 15th St NW Ste 207",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242731600",
            "country_code": "US",
            "telephone_number": "276-439-1490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046035",
            "country_code": "US",
            "telephone_number": "423-431-6111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1485 Flatwoods Rd",
            "address_purpose": "LOCATION",
            "city": "Coeburn",
            "state": "VA",
            "postal_code": "242303738",
            "country_code": "US",
            "telephone_number": "276-219-4378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2202 N John B Dennis Hwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376605904",
            "country_code": "US",
            "telephone_number": "423-578-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "HEATHER",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024190898",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "36787",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

Verify at the official NPI Registry.