Kaitlyn Anne Averett, FNPC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

25512 Issued in TN

Practice address

107 JV Mangubat Dr
Waynesboro, TN 38485-2440

Phone

(931) 722-2800

Fax

(931) 722-9627

NPI assigned

Mar 14, 2019

Last updated

Feb 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kaitlyn Anne Kelly 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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hallmedical Clinic LLCGroup PAC ID 5890184931, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wayne Medical Center Hospital, Waynesboro, TN, CCN 440780

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

• Hallmedical Clinic LLC

  • Family Medicine Physician
  • Waynesboro, TN
  • NPI 1952065328
  Medicare reassignment Care Compare group NPD

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

• Maury Regional Hospital

  dba Wayne Medical Center

  • General Acute Care Hospital
  • Waynesboro, TN
  • NPI 1811927544
  Care Compare affiliation

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

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1780143297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384850689",
            "telephone_number": "931-722-2800",
            "fax_number": "931-722-9627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 JV MANGUBAT DR",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384852440",
            "telephone_number": "931-722-2800",
            "fax_number": "931-722-9627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERETT",
        "first_name": "KAITLYN",
        "middle_name": "ANNE",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-14",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "25512",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "APN25512",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "KELLY",
            "middle_name": "ANNE",
            "credential": "APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amg Crockett LLC (Your Family Clinic)
• Tara Anderson
• Janice Kay Andrews, R.N.
• Nancy A. Armetta, MD
• At Home Meds, LLC
• Lucas Baker
• Erica Barnett, RN
• Olivia Kathryn Barrington, PHARM.D.
• Adam Freeman Bedwell, PT, DPT
• Lindsey Lauren Benson, PHARM.D.

• Family Nurse Practitioner in Waynesboro, TN
• Providers in Waynesboro, 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 Feb 4, 2021; 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.