Active NPI
Maureen A Gaynor, ARNP
- Psychiatric/Mental Health Clinical Nurse Specialist
- Kingsport, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Clinical Nurse Specialist
- License
- 21311
- Practice address
- 1570 Waverly Rd
Kingsport, TN 37664-2523 - Phone
- (423) 224-1300
- Fax
- (423) 467-3644
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 049181-23-08 | NH | |
| Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0808X | 21311 | TN | Primary |
Addresses
Primary practice location
1570 Waverly Rd
Kingsport, TN 37664-2523
Mailing address
1167 Spratlin Park Dr
Gray, TN 37615-6205
Phone (423) 467-3600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH, TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1167 Spratlin Park Dr
Gray, TN 37615-6205
Phone (423) 467-3600
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frontier Health | Current | Accepting new patients | |
| Merrimack Valley Counseling Association | Psychiatric/Mental Health | Current | Accepting new patients |
| Frontier Health | Current | Accepting new patients | |
| Christiana Care Health Services Inc | Past | Accepting new patients | |
| Christiana Care Health Services, Inc | Past | Accepting new patients |
Locations
39 Simon St
Ste 2A
Nashua, NH 03060
Phone (603) 888-4347
39 Simon St
Ste 2
Nashua, NH 03060
1145 Volunteer Pkwy
Bristol, TN 37620
Phone (423) 989-4500
426 E G St
Elizabethton, TN 37643
Phone (423) 547-5950
218 N Main Ave
Erwin, TN 37650
Phone (423) 741-8263
401 Holston Dr
Greeneville, TN 37743
Phone (423) 639-1104
109 W Watauga Ave
Johnson City, TN 37604
Phone (423) 232-2600
1167 Spratlin Park Dr
Johnson City, TN 37615
Phone (423) 232-2670
607 Baxter St
Johnson City, TN 37601
Phone (423) 232-2670
1570 Waverly Rd
Kingsport, TN 37664
Phone (423) 224-1300
318 Donnelly St
Mountain City, TN 37683
Phone (423) 727-2100
101 Lena Dr
Rogersville, TN 37857
Phone (423) 272-9239
210 River Rd
Sneedville, TN 37869
Phone (423) 733-2061
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/5c7467fb-60f9-4172-add4-57667a5dfcfa/
Organizations & group practices 5
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Gray, TN
- NPI 1720147408
-
- Psychologist
- Nashua, NH
- NPI 1508905472
Psychiatric/Mental Health
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Sneedville, TN
- NPI 1053475558
-
- Infectious Disease Physician
- Wilmington, DE
- NPI 1326022476
-
- Cardiovascular Disease Physician
- Newark, DE
- NPI 1003850504
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484006400000",
"number": "1730230681",
"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",
"telephone_number": "423-467-3600",
"fax_number": "423-467-3644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1570 WAVERLY RD",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376642523",
"telephone_number": "423-224-1300",
"fax_number": "423-467-3644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAYNOR",
"first_name": "MAUREEN",
"middle_name": "A",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2017-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NH",
"license": "049181-23-08",
"primary": false
},
{
"code": "364SP0808X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
"state": "TN",
"license": "21311",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.