Individual provider Active NPI

Kristin Smith

  • Family Nurse Practitioner
  • Cookeville, TN
National Provider Identifier
1811865967
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
40301 Issued in TN
Practice address
768 S Willow Ave Ste a
Cookeville, TN 38501-3892
Phone
(931) 559-6900
Fax
(931) 548-6909
NPI assigned
Oct 29, 2025
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 40301 TN Primary

Addresses

Primary practice location

768 S Willow Ave Ste a
Cookeville, TN 38501-3892

Mailing address

768 S Willow Ave Ste a
Cookeville, TN 38501-3892
Phone (931) 559-6900

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
I20251231002603 TN Practitioner - Nurse Practitioner 8123514940 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

321 E Central Ave
Jamestown, TN 38556-4103
Phone (931) 879-0206

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 8, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 8, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Dec 8, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Dec 8, 2025 Accepting new patients

Locations

2324 Congress Pkwy S
Athens, TN 37303
Phone (423) 744-9399

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

321 Central Ave E
Jamestown, TN 38556
Phone (931) 704-9188

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.

NPI Registry JSON

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

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1811865967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "768 S WILLOW AVE STE A",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013892",
            "telephone_number": "931-559-6900",
            "fax_number": "931-548-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "768 S WILLOW AVE STE A",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013892",
            "telephone_number": "931-559-6900",
            "fax_number": "931-548-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-29",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "40301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.