Individual provider Active NPI

Nathan Robert Hitchcock, DNP

  • Family Nurse Practitioner
  • Mountain City, TN
National Provider Identifier
1801318126
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024180499 Issued in VA
Practice address
1901 S Shady St
Mountain City, TN 37683-2021
Phone
(423) 727-1150
NPI assigned
Jul 7, 2017
Last updated
Dec 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 23005 TN
Family Nurse Practitioner 363LF0000X 0000185999 TN
Family Nurse Practitioner 363LF0000X 0024180499 VA Primary
Registered Nurse 163W00000X 0000185999 TN

Addresses

Primary practice location

1901 S Shady St
Mountain City, TN 37683-2021

Mailing address

509 Med Tech Pkwy Ste 100
Johnson City, TN 37604-2579
Phone (423) 302-6565

Other practice location 1

16000 Johnston Memorial Dr Fl 4
Abingdon, VA 24211-7664
Phone (276) 258-4050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000185999TNMDFamily Nurse Practitioner
0024180499VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Current Accepting new patients

Locations

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

Interoperability endpoints

  • Direct secure messaging: nathan.hitchcock.1@17155.direct.athenahealth.com

Organizations & group practices 1

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": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1801318126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 MED TECH PKWY STE 100",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042579",
            "telephone_number": "423-302-6565",
            "fax_number": "423-952-2175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S SHADY ST",
            "city": "MOUNTAIN CITY",
            "state": "TN",
            "postal_code": "376832021",
            "telephone_number": "423-727-1150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16000 Johnston Memorial Dr Fl 4",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242117664",
            "country_code": "US",
            "telephone_number": "276-258-4050",
            "fax_number": "276-258-4056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HITCHCOCK",
        "first_name": "NATHAN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-07",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "23005",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "0000185999",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024180499",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "0000185999",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.