Individual provider Active NPI

Katelyn Woods, PA-C

  • Physician Assistant
  • Harrogate, TN
National Provider Identifier
1750102687
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6243 Issued in TN
Practice address
6965 Cumberland Gap Pkwy
Harrogate, TN 37752
Phone
(423) 869-3611
NPI assigned
Oct 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6243 TN Primary

Addresses

Primary practice location

6965 Cumberland Gap Pkwy
Harrogate, TN 37752

Mailing address

PO Box 26
Mountain Home, TN 37684

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
I20250313001952 TN Practitioner - Physician Assistant 1355863861 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

100 E Tennessee St
Collinwood, TN 38450
Phone (931) 724-9000

1800 W Market St
Johnson City, TN 37604-6023
Phone (931) 253-1110

805 W Jackson Blvd
Jonesborough, TN 37659-5270
Phone (423) 850-8190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6243TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jan 31, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jan 31, 2025 Accepting new patients

Locations

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

3430 E Andrew Johnson Hwy
Greeneville, TN 37745
Phone (423) 820-0033

2280 S Shady St
Mountain City, TN 37683
Phone (423) 501-2165

Organizations & group practices 4

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": "1729641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1750102687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "37684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6965 CUMBERLAND GAP PKWY",
            "city": "HARROGATE",
            "state": "TN",
            "postal_code": "37752",
            "telephone_number": "423-869-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "KATELYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrogate, TN

Sources for this page

Verify at the official NPI Registry.