Individual provider Active NPI

Kayla Renee Brummitte Newcomb, FNP-C, BSN, RN

  • Family Nurse Practitioner
  • Maynardville, TN
National Provider Identifier
1720374697
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F0911356 Issued in TN
Practice address
598 John Deere Dr
Maynardville, TN 37807-3212
Phone
(865) 745-1868
Fax
(865) 745-1873
NPI assigned
Jun 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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 F0911356 TN Primary

Addresses

Primary practice location

598 John Deere Dr
Maynardville, TN 37807-3212

Mailing address

598 John Deere Dr
Maynardville, TN 37807-3212
Phone (865) 745-1868

Other identifiers 1

IdentifierTypeStateIssuer
1527270MedicaidTN

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
I20120208000884 TN Practitioner - Nurse Practitioner 2668639287 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
F0911356TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit View Health Services, LLC Family CurrentSince Nov 9, 2015 Accepting new patients
Summit View Health Services LLC Family CurrentSince Nov 9, 2015 Accepting new patients
Urgent Care Across America Past Accepting new patients

Locations

10805 Harding Dr
Knoxville, TN 37932
Phone (865) 675-6444

598 John Deere Dr
Maynardville, TN 37807
Phone (865) 745-1868

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1720374697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 JOHN DEERE DR",
            "city": "MAYNARDVILLE",
            "state": "TN",
            "postal_code": "378073212",
            "telephone_number": "865-745-1868",
            "fax_number": "865-745-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 JOHN DEERE DR",
            "city": "MAYNARDVILLE",
            "state": "TN",
            "postal_code": "378073212",
            "telephone_number": "865-745-1868",
            "fax_number": "865-745-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMMITTE NEWCOMB",
        "first_name": "KAYLA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C, BSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "F0911356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1527270",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maynardville, TN

Sources for this page

Verify at the official NPI Registry.