Individual provider Active NPI

Christy Willocks, FNP

  • Family Nurse Practitioner
  • Kingsport, TN
National Provider Identifier
1710906144
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
119820 Issued in TN
Practice address
2050 Meadowview Pkwy
Kingsport, TN 37660-7332
Phone
(423) 230-5000
Fax
(423) 230-5010
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 119820 TN Primary

Addresses

Primary practice location

2050 Meadowview Pkwy
Kingsport, TN 37660-7332

Mailing address

2050 Meadowview Pkwy
Kingsport, TN 37660-7332
Phone (423) 230-5000

Other identifiers 3

IdentifierTypeStateIssuer
010011469MedicaidVA
0191OtherILJOHN DEERE
3909537MedicaidTN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100528000351 TN Practitioner - Nurse Practitioner 3870622996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Cardiology ServicesGroup PAC ID 5799970281, 137 clinicians

Practice addresses (Care Compare)

2050 Meadowview Pkwy
Kingsport, TN 37660-7475
Phone (423) 230-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
119820TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates Inc Nurse Practitioner Current Accepting new patients
Wellmont Cardiology Services Nurse Practitioner CurrentSince Jan 1, 2011 Accepting new patients

Locations

378 Marketplace Blvd
Ste 10
Johnson City, TN 37604
Phone (423) 928-2030

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

2033 Meadowview Ln
Kingsport, TN 37660
Phone (423) 230-6040

2050 Meadowview Pkwy
Kingsport, TN 37660

Organizations & group practices 2

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.

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1710906144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 MEADOWVIEW PKWY",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607332",
            "telephone_number": "423-230-5000",
            "fax_number": "423-230-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 MEADOWVIEW PKWY",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607332",
            "telephone_number": "423-230-5000",
            "fax_number": "423-230-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOCKS",
        "first_name": "CHRISTY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "119820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010011469",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "0191",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3909537",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.