Individual provider Active NPI

Kelsey Shasteen

  • Adult Health Nurse Practitioner
  • Murfreesboro, TN
National Provider Identifier
1730742479
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
29455 Issued in TN
Practice address
2548 Rideout LN
Murfreesboro, TN 37128-7686
Phone
(615) 410-4990
Fax
(615) 410-4250
NPI assigned
Apr 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 29455 TN Primary
Registered Nurse 163W00000X 0000214051 TN

Addresses

Primary practice location

2548 Rideout LN
Murfreesboro, TN 37128-7686

Mailing address

2548 Rideout LN
Murfreesboro, TN 37128-7686
Phone (615) 410-4990

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
I20211119001337 TN Practitioner - Nurse Practitioner 9638568280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2548 Rideout LN
Murfreesboro, TN 37128-7686
Phone (615) 410-4990

Merit-based Incentive Payment System (MIPS)

Final score
71.98 of 100Reported as group
Quality
27.23
Promoting interoperability
94
Improvement activities
40
Cost
75.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000214051TNMDRegistered Nurse
29455TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Neurology Center, PLLC CurrentSince Sep 1, 2021 Accepting new patients
Comprehensive Neurology Center, PLLC CurrentSince Sep 1, 2021 Accepting new patients

Locations

1812 Haynes St
Clarksville, TN 37043
Phone (931) 552-1352

1400 Hatcher Ln
Columbia, TN 38401
Phone (931) 381-7000

4321 Carothers Pkwy
Franklin, TN 37067
Phone (615) 435-5000

3901 Central Pike
Ste 257
Hermitage, TN 37076
Phone (615) 859-7546

2140 N Thompson Ln
Ste 100
Murfreesboro, TN 37129

2548 Rideout Ln
Murfreesboro, TN 37128
Phone 61541049901007

Interoperability endpoints

  • Direct secure messaging: kelsey.shasteen.1@30188.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1730742479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2548 RIDEOUT LN",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371287686",
            "telephone_number": "615-410-4990",
            "fax_number": "615-410-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2548 RIDEOUT LN",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371287686",
            "telephone_number": "615-410-4990",
            "fax_number": "615-410-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHASTEEN",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TN",
            "license": "29455",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "0000214051",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.