Individual provider Active NPI

Michelle Sonnichsen-Kumm

  • Family Nurse Practitioner
  • Mount Juliet, TN
National Provider Identifier
1821610668
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27569 Issued in TN
Practice address
3500 N Mount Juliet Rd Ste 201
Mt Juliet, TN 37122-3059
Phone
(615) 758-5672
NPI assigned
May 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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 27569 TN Primary

Addresses

Primary practice location

3500 N Mount Juliet Rd Ste 201
Mt Juliet, TN 37122-3059

Mailing address

3500 N Mount Juliet Rd Ste 201
Mt Juliet, TN 37122-3059
Phone (615) 758-5672

Other practice location 1

406 Avalon Isle
MT Juliet, TN 37122-2287
Phone (615) 478-2564

Other practice location 2

562 W Main St
Cookeville, TN 38506-5382
Phone (931) 854-9602

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
I20201013001424 TN Practitioner - Nurse Practitioner 7113347105 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Oct 5, 2020 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Oct 5, 2020 Accepting new patients
Silver Hill Medical Clinic PastSince Nov 1, 2022 Accepting new patients

Locations

562 W Main St
Cookeville, TN 38506
Phone (931) 854-9601

817 W Main St
Livingston, TN 38570
Phone (931) 219-2091

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17845/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1821610668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N MOUNT JULIET RD STE 201",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371223059",
            "telephone_number": "615-758-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 N MOUNT JULIET RD STE 201",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371223059",
            "telephone_number": "615-758-5672"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "406 Avalon Isle",
            "address_purpose": "LOCATION",
            "city": "MT Juliet",
            "state": "TN",
            "postal_code": "371222287",
            "country_code": "US",
            "telephone_number": "615-478-2564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "562 W Main St",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385065382",
            "country_code": "US",
            "telephone_number": "931-854-9602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONNICHSEN-KUMM",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-14",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Juliet, TN

Sources for this page

Verify at the official NPI Registry.