Wanda Faye Keagle, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

16167 Issued in TN

Practice address

586 S Jefferson Ave Ste L
Cookeville, TN 38501-4637

Phone

(931) 854-0050

Fax

(931) 854-0411

NPI assigned

Oct 17, 2011

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

• Mrs. Wanda Faye Wilson Former name

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hometown Family Care, LLCGroup PAC ID 6305073933, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059

Merit-based Incentive Payment System (MIPS)

Final score

39.55 of 100Reported as individual

Quality

25

Improvement activities

0

Cost

92.1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

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.

• Hometown Family Care, LLC

  • Family Nurse Practitioner
  • Cookeville, TN
  • NPI 1790113553
  Medicare reassignment Care Compare group NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cookeville Regional Medical Center

  • General Acute Care Hospital
  • Cookeville, TN
  • NPI 1275531956
  Care Compare affiliation

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1740565282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "586 S JEFFERSON AVE STE L",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014637",
            "telephone_number": "931-854-0050",
            "fax_number": "931-854-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 S JEFFERSON AVE STE L",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014637",
            "telephone_number": "931-854-0050",
            "fax_number": "931-854-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEAGLE",
        "first_name": "WANDA",
        "middle_name": "FAYE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "16167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "WILSON",
            "middle_name": "FAYE",
            "prefix": "MRS.",
            "credential": "ANP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rowan Karlavage
• Peggy Louann Karlosky, PH.D.
• Stephanie Karlosky, LPC/MHSP
• Rohini Kasturi, M.D
• Rohan Kataria, M.D.
• Cody Keck, DPT
• Kathryn Keck, DPT
• Scott H Keith, MD
• Dana Leann Kelly
• Erin Marlene Kelly, LMFT

• Family Nurse Practitioner in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; 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.