Kaitlynn Earls, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26158 Issued in TN

Practice address

401 Holston Dr
Greeneville, TN 37743-3127

Phone

(423) 639-1104

Fax

(423) 467-3644

NPI assigned

Jan 2, 2019

Last updated

Jun 3, 2020By 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

Other names 1

• Miss Kaitlynn Puckett Former name

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

Lincoln Memorial University Medical Department, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Frontier HealthGroup PAC ID 2860302320, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Frontier Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gray, TN
  • NPI 1720147408
  Medicare reassignment Care Compare group NPD
• Frontier Health

  dba Hancock County Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sneedville, TN
  • NPI 1053475558
  NPD

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1710459706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 SPRATLIN PARK DR",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376156205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HOLSTON DR",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377433127",
            "telephone_number": "423-639-1104",
            "fax_number": "423-467-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLS",
        "first_name": "KAITLYNN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-02",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "26158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYNN",
            "last_name": "PUCKETT",
            "prefix": "MISS",
            "credential": "R.N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Michael Durante, BCBA
• David J Dykes, DDS
• E. Bradford Strange, P.C.
• Elizabeth Sue Ealy, R.PH.
• Rick Eugene Ealy, D.PH.
• East Tenn. Medical Trans.
• East Tennessee Cancer & Blood Center,PC
• East Tennessee Internal Medicine Associates PC C/O Brooks Morelock
• East Tennessee Oral & Maxillofacial Surgery, PC
• East Tennessee Pulmonary and Sleep Medicine PLLC

• Psychiatric/Mental Health Nurse Practitioner in Greeneville, TN
• Providers in Greeneville, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.