Individual provider Active NPI

Michelle M Meade, NP

  • Family Nurse Practitioner
  • Bristol, TN
National Provider Identifier
1790136489
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21552 Issued in TN
Practice address
1 Medical Park Blvd
Sutie 458W
Bristol, TN 37620-7430
Phone
(423) 844-4800
Fax
(423) 230-6905
NPI assigned
Jun 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21552 TN Primary
Registered Nurse 163W00000X 0001194339 VA

Addresses

Primary practice location

1 Medical Park Blvd
Sutie 458W
Bristol, TN 37620-7430

Mailing address

105 W Stone Dr
Suite 6a
Kingsport, TN 37660-3365
Phone (423) 408-7220

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
I20160824001335 TN Practitioner - Nurse Practitioner 6204121676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Cardiology ServicesGroup PAC ID 5799970281, 137 clinicians

Practice addresses (Care Compare)

2050 Meadowview Pkwy
Kingsport, TN 37660-7475
Phone (423) 230-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001194339VAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates Inc Current Accepting new patients
Wellmont Cardiology Services Family CurrentSince Aug 12, 2016 Accepting new patients
Wellmont Medical Associates, Inc. PastSince Sep 1, 2019 Accepting new patients

Locations

1 Medical Park Blvd
Ste 458W
Bristol, TN 37620
Phone (423) 230-6900

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

2050 Meadowview Pkwy
Kingsport, TN 37660

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

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1790136489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W STONE DR",
            "address_2": "SUITE 6A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-408-7220",
            "fax_number": "423-408-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD",
            "address_2": "SUTIE 458W",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207430",
            "telephone_number": "423-844-4800",
            "fax_number": "423-230-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEADE",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21552",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001194339",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.