Misty Dawn Dockery, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN0000024681 Issued in TN

Practice address

4485 W Stone Dr
Kingsport, TN 37660-1487

Phone

(423) 578-8500

Fax

(423) 578-8590

NPI assigned

Oct 18, 2018

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

• Misty Dawn Holbrook Former name

Medicare fee-for-service enrollment

Enrolled in TN, VA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Brody School of Medicine at East Carolina University, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

WPS Providers IncGroup PAC ID 7719079532, 83 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• WPS Providers Inc

  • General Practice Physician
  • Kingsport, TN
  • NPI 1003904095

  TN, VA

  Medicare reassignment Care Compare group NPD
• Blue Ridge Medical Management Corporation

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833

  TN

  Medicare reassignment NPD
• Blue Ridge Medical Management Corporation

  • Cardiovascular Disease Physician
  • Marion, VA
  • NPI 1326159567

  VA

  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  TN

  Medicare reassignment NPD
• Blue Ridge Medical Management Corporation

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1053762112
  NPD
• Blue Ridge Medical Management Corporation

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1982553756
  NPD
• Wellmont Medical Associates Inc

  • Pulmonary Disease Physician
  • Kingsport, TN
  • NPI 1780986257
  NPD
• Blue Ridge Medical Management Corporation

  • Hospitalist Physician
  • Abingdon, VA
  • NPI 1104171826
  NPD
• Wellmont Hawkins County Memorial Hospital Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Rogersville, TN
  • NPI 1245260660
  NPD (past)

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1730655671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4485 W STONE DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376601487",
            "telephone_number": "423-578-8500",
            "fax_number": "423-578-8590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2421 N John B Dennis Hwy",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376604773",
            "country_code": "US",
            "telephone_number": "423-288-3988",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2202 N John B Dennis Hwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376605904",
            "country_code": "US",
            "telephone_number": "423-578-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Park Blvd Ste 210E",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207468",
            "country_code": "US",
            "telephone_number": "423-844-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "98 15th St NW Ste 207",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242731600",
            "country_code": "US",
            "telephone_number": "276-439-1295",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Professional Park Dr Ste 31",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046529",
            "country_code": "US",
            "telephone_number": "423-631-0543",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046035",
            "country_code": "US",
            "telephone_number": "423-431-6111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Brookside Dr",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376604627",
            "country_code": "US",
            "telephone_number": "423-857-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Park Blvd Ste 3W",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207430",
            "country_code": "US",
            "telephone_number": "423-844-1121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 W Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603837",
            "country_code": "US",
            "telephone_number": "423-224-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOCKERY",
        "first_name": "MISTY",
        "middle_name": "DAWN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-18",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000024681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISTY",
            "last_name": "HOLBROOK",
            "middle_name": "DAWN",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brittany Dixon
• Mark C Dixon, MD
• DLS Ventures, LLC.
• Jana Dobesova, LPC-MHSP
• Holly Dillon Dockery, DNP, AGPCNP-BC, RN
• Elizabeth Ann Dodd, CCC-SLP
• Robert J Doell, MD
• Lindsey D Dollar, PA-C
• Danielle Donahue, PA-C
• Matthew David Donaldson, COTA/L

• All providers in Kingsport, TN
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.