Individual provider Active NPI

Michelle Lee Hale, FNP-BC

  • Family Nurse Practitioner
  • Greeneville, TN
National Provider Identifier
1740654714
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20686 Issued in TN
Practice address
318 Tusculum Blvd
Greeneville, TN 37745-3926
Phone
(423) 639-7700
Fax
(423) 639-7702
NPI assigned
Nov 13, 2015
Last updated
Dec 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 20686 TN Primary

Addresses

Primary practice location

318 Tusculum Blvd
Greeneville, TN 37745-3926

Mailing address

201 Cherry Grove Rd
Jonesborough, TN 37659-6951
Phone (423) 291-2567

Other practice location 1

1500 W Elk Ave
Elizabethton, TN 37643-2654
Phone (423) 547-0852

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
I20240614000147 TN Practitioner - Nurse Practitioner 5991248361 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20686TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
King's Way Family Medicine, LLC CurrentSince Dec 21, 2021 Accepting new patients
CS Pacs 3 Southeast, LLC CurrentSince Jul 16, 2024 Accepting new patients
NV Pacs 2 LLC CurrentSince May 1, 2024 Accepting new patients

Locations

880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669

318 Tusculum Blvd
Greeneville, TN 37745
Phone (423) 639-7700

115 Woodlawn Dr
Johnson City, TN 37604
Phone (423) 943-0956

140 Technology Ln
Johnson City, TN 37604
Phone (423) 434-2016

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1740654714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 CHERRY GROVE RD",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376596951",
            "telephone_number": "423-291-2567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 TUSCULUM BLVD",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377453926",
            "telephone_number": "423-639-7700",
            "fax_number": "423-639-7702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 W Elk Ave",
            "address_purpose": "LOCATION",
            "city": "Elizabethton",
            "state": "TN",
            "postal_code": "376432654",
            "country_code": "US",
            "telephone_number": "423-547-0852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALE",
        "first_name": "MICHELLE",
        "middle_name": "LEE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-13",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "20686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeneville, TN

Sources for this page

Verify at the official NPI Registry.