Individual provider Active NPI

Autumn R Hoover, NP

  • Nurse Practitioner
  • Kingsport, TN
National Provider Identifier
1790037240
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
17043 Issued in TN
Practice address
105 W Stone Dr
Ste 2B
Kingsport, TN 37660-3365
Phone
(423) 247-7500
NPI assigned
Oct 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 17043 TN Primary

Addresses

Primary practice location

105 W Stone Dr
Ste 2B
Kingsport, TN 37660-3365

Mailing address

PO Box 9
Kingsport, TN 37662-0009
Phone (423) 857-2066

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
I20121127000287 TN Practitioner - Nurse Practitioner 7214188168 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
East Tennessee State University Quillen College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holston Medical Group PCGroup PAC ID 8224935754, 239 clinicians

Practice addresses (Care Compare)

105 W Stone Dr
Kingsport, TN 37660-3365
Phone (423) 247-7500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17043TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates Inc Nurse Practitioner CurrentSince Oct 5, 2012 Accepting new patients
Holston Medical Group PC Nurse Practitioner CurrentSince Jun 15, 2015 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Oct 5, 2012 Accepting new patients
Wellmont Physician Services Inc Nurse Practitioner Past Accepting new patients
Southwest Virginia Physicians for Women PastSince Jun 15, 2015 Accepting new patients

Locations

350 Steeles Rd
#1
Bristol, TN 37620
Phone (423) 844-4925

320 Bristol West Blvd
Ste 2C
Bristol, TN 37620
Phone (423) 844-1399

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

135 W Ravine Rd
Ste 1-A
Kingsport, TN 37660
Phone (423) 224-4920

2204 Pavilion Dr
Ste 200
Kingsport, TN 37660
Phone (423) 224-3900

105 W Stone Dr
Ste 2B
Kingsport, TN 37660
Phone (423) 247-7500

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

105 W Stone Dr
Ste 5D
Kingsport, TN 37660
Phone (423) 247-7500

Interoperability endpoints

  • Direct secure messaging: autumnhoover@hmgpath.allscriptsdirect.net

Organizations & group practices 5

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": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1790037240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376620009",
            "telephone_number": "423-857-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W STONE DR",
            "address_2": "STE 2B",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-247-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOVER",
        "first_name": "AUTUMN",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "17043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.