Fay Lynn Bembry, NP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Johnson City, TN
NPI 1811098908 · NPPES record last updated May 28, 2014
Key facts
- NPI
- 1811098908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- APN6745 (TN)
- Practice address
- 119 Boone Ridge Drive Ste. 201
Johnson City, TN 37615 - Phone
- (423) 282-7480
- Fax
- (423) 928-1353
- NPI assigned
- Sep 25, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- NV Pacs 2 LLC
Southeastern Physician Services PC
BH Services Southeast 1 PC
Ipc Pac Healthcare Services of Tennessee PC
Practice addresses (Care Compare)
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 844-5916
103 N St
Bristol, VA 24201-3201
Phone (276) 246-7240
18 N Cavalier Dr
Alamo, TN 38001-6468
Phone (731) 696-4500
2012 Sherwood Dr
Johnson City, TN 37601-3238
Phone (423) 928-3168
400 Professional Park PVT Dr
Kingsport, TN 37663-2234
Phone (423) 239-0022
505 N Roan St
Johnson City, TN 37601-4740
Phone (423) 975-2000
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.72 of 100
- Quality
- 72.97
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060403000488 | TN | Practitioner - Nurse Practitioner | 6305854308 | Reassigns benefits to 7 organizations |
| I20070712000258 | VA | Practitioner - Nurse Practitioner | 6305854308 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6745 | TN | MD | Surgical Physician Assistant |
| APN6745 | TN | MD | Psychiatric/Mental Health Nurse Practitioner |
| 0024167103 | VA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SBH-Kingsport | Current |
Accepting new patients | |
| Medpsych Inc. PC | Current |
Accepting new patients | |
| SBH-Kingsport | Current |
Accepting new patients | |
| CS Pacs 3 Southeast, LLC | Current |
Accepting new patients | |
| Virginia Pac Services PC | Current |
Accepting new patients | |
| NV Pacs 2 LLC | Current |
Accepting new patients | |
| BH Services Southeast 1 PC | Current |
Accepting new patients | |
| Southeastern Physician Services PC | Current |
Accepting new patients |
Locations
1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325
18 N Cavalier Dr
Alamo, TN 38001
Phone (731) 696-4500
1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451
2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000
880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669
1025 Executive Park Blvd
Kingsport, TN 37660
Phone (423) 765-0777
1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061
600 Waldon Rd NE
Abingdon, VA 24210
Phone (276) 628-2111
15051 Harmony Hills Ln
Abingdon, VA 24211
Phone (276) 451-2590
103 North St
Bristol, VA 24201
Phone (276) 642-7901
2966 Slate Creek Rd
Grundy, VA 24614
Phone (276) 935-8144
1 Vantage Dr
Poquoson, VA 23662
Phone (757) 868-9660
600 W Ridge Rd
Wytheville, VA 24382
Phone (276) 228-0200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APN6745 | TN | Yes |
| Family Nurse Practitioner | 363LF0000X | 6745 | TN | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 0024167103 | VA |
Addresses
Primary practice location
119 Boone Ridge Drive Ste. 201
Johnson City, TN 37615
Mailing address
119 Boone Ridge Drive Ste. 201
Johnson City, TN 37615
Phone (423) 282-7480
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3347678 | Medicaid | TN |
Other names
- Fay Lynn Hardison
Other providers in Johnson City, TN
- Arthur William Belanger
- Sarah E. Belcher
- Kimberley A Bell
- Randall L Belt
- Whitney L Belt
- Shannon Bemiss
- Fernando Bendfeldt
- Kathy A Benedetto
- Michael Arthur Benoit
- Paul Michael Benson
All providers in Johnson City, TN · Psychiatric/Mental Health Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.