Individual provider Active NPI

Caroline Kincaid

  • Certified Registered Nurse Anesthetist
  • Harrogate, TN
National Provider Identifier
1720764483
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
227987 Issued in TN
Practice address
6965 Cumberland Gap Pkwy
Harrogate, TN 37752-8245
Phone
(423) 869-3611
NPI assigned
Jun 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 227987 TN Primary

Addresses

Primary practice location

6965 Cumberland Gap Pkwy
Harrogate, TN 37752-8245

Mailing address

1081 Raccoon LN
Piney Flats, TN 37686-2929

Other practice location 1

10415 Wallace Alley St
Kingsport, TN 37663-3936
Phone (423) 968-4050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250201000120 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638608870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Lincoln Memorial University Medical Department, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Anesthesia PCGroup PAC ID 8921044744, 214 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 390-0451

300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 390-0451

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 390-0451

Hospital & facility affiliations

  • Franklin Woods Community Hospital Hospital, Johnson City, TN, CCN 440184
  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
227987TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Ambulatory Surgery Center LLC CurrentSince Jan 10, 2025 Accepting new patients
Paragon Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Jan 10, 2025 Accepting new patients
Singing River Health System Past Accepting new patients

Locations

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451

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.

Hospital & facility affiliations 4

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": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1720764483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 RACCOON LN",
            "city": "PINEY FLATS",
            "state": "TN",
            "postal_code": "376862929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6965 CUMBERLAND GAP PKWY",
            "city": "HARROGATE",
            "state": "TN",
            "postal_code": "377528245",
            "telephone_number": "423-869-3611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10415 Wallace Alley St",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376633936",
            "country_code": "US",
            "telephone_number": "423-968-4050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINCAID",
        "first_name": "CAROLINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "227987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrogate, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.