Kelly M Hare, F.N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

12652 Issued in TN

Practice address

2205 Pavilion Dr
Suite 201B
Kingsport, TN 37660-4641

Phone

(423) 857-7650

Fax

(423) 857-7655

NPI assigned

Mar 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN, VA2 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

Specialty

Nurse Practitioner

Education

East Tennessee State University Quillen College of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
• Russell County Hospital Hospital, Lebanon, VA, CCN 490002
• Johnston Memorial Hospital Hospital, Abingdon, VA, CCN 490053

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wellmont Medical Associates Inc

  • Pulmonary Disease Physician
  • Kingsport, TN
  • NPI 1780986257

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Blue Ridge Medical Management Corporation

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833
  Medicare reassignment NPD
• Blue Ridge Medical Management Corporation

  • Cardiovascular Disease Physician
  • Marion, VA
  • NPI 1326159567
  Medicare reassignment NPD
• Blue Ridge Medical Management Corporation

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1053762112
  NPD
• Blue Ridge Medical Management Corporation

  • Cardiovascular Disease Physician
  • Abingdon, VA
  • NPI 1902938871
  NPD
• Blue Ridge Medical Management Corporation

  • Cardiovascular Disease Physician
  • Johnson City, TN
  • NPI 1740227131
  NPD (past)

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

• Wellmont Health System

  • General Acute Care Hospital
  • Bristol, TN
  • NPI 1124058615
  Care Compare affiliation
• Johnston Memorial Hospital, Inc

  • General Acute Care Hospital
  • Abingdon, VA
  • NPI 1104812684
  Care Compare affiliation
• Mountain States Health Alliance

  • General Acute Care Hospital
  • Lebanon, VA
  • NPI 1891973939
  Care Compare affiliation

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1821115676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 PAVILION DR",
            "address_2": "SUITE 201B",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604641",
            "telephone_number": "423-857-7650",
            "fax_number": "423-857-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 PAVILION DR",
            "address_2": "SUITE 201B",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604641",
            "telephone_number": "423-857-7650",
            "fax_number": "423-857-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARE",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "12652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100023580",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01662016",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q016582",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel K. Hammonds, CRNA
• Hanger Prosthetics & Orthotics Inc
• Whitney Hanor, PA-C, ATC
• Rebekah Sunshine Harding, BA
• Charles Matthew Hardman, BA
• Angela Harless, FNP
• Heather Harmon, PT
• Kelly E Harness, NP
• Michael Harr, PHARMD
• Aaron Harrell

• Nurse Practitioner in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.