Individual provider Active NPI

Nickie Ann Rosario, FNP-BC, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1801355466
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
25511 Issued in TN
Practice address
975 E 3Rd St
Chattanooga, TN 37403-2147
Phone
(423) 778-7000
NPI assigned
Mar 13, 2019
Last updated
Dec 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 25511 TN Primary
Family Nurse Practitioner 363LF0000X RN284659 GA
Family Nurse Practitioner 363LF0000X 25511 TN

Addresses

Primary practice location

975 E 3Rd St
Chattanooga, TN 37403-2147

Mailing address

PO Box 22971
Chattanooga, TN 37422-2971
Phone (423) 503-2414

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Katherine.Andrews@erlanger.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191119000254 TN Practitioner - Nurse Practitioner 3274965959 Reassigns benefits to 1 organization
I20191126003014 GA Practitioner - Nurse Practitioner 3274965959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Gross Crescent Cir
Fort Oglethorpe, GA 30742-3643
Phone (706) 858-2445

2051 Hamill Rd
Hixson, TN 37343-6614
Phone (423) 495-7353

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25511TNMDAcute Care Nurse Practitioner
RN284659GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Therapies PLLC CurrentSince Sep 2, 2019 Accepting new patients
Memorial Health Partners Foundation Inc CurrentSince Aug 1, 2020 Accepting new patients
Memorial Health Partners Foundation, Inc CurrentSince Aug 1, 2020 Accepting new patients
LHCG Lxxiv, LLC Past Accepting new patients

Locations

100 Gross Crescent Cir
Ft Oglethorpe, GA 30742
Phone (706) 858-2301

88 Stuart Rd
Ste 88
Ft Oglethorpe, GA 30742
Phone (423) 521-5404

611 E Villanow St
La Fayette, GA 30728
Phone (706) 638-1606

1949 Gunbarrel Rd
Ste 206
Chattanooga, TN 37421
Phone (423) 495-4345

5600 Brainerd Rd
Ste 500
Chattanooga, TN 37411
Phone (423) 414-3586

Interoperability endpoints

  • Direct secure messaging: katherine.andrews@erlanger.org

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

Hospital & facility affiliations 3

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": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1801355466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22971",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374222971",
            "telephone_number": "423-503-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 E 3RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032147",
            "telephone_number": "423-778-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "NICKIE",
        "middle_name": "ANN",
        "credential": "FNP-BC,  ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "25511",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN284659",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "25511",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Katherine.Andrews@erlanger.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "975 E 3rd St",
            "city": "Chattanooga",
            "state": "TN",
            "country_code": "US",
            "postal_code": "374032147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.