Tina Kelly, MSN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

34204 Issued in TN

Practice address

McCoy Medical
1324 South Home Street
Union City, TN 38261

Phone

(731) 885-8881

NPI assigned

Jun 14, 2023

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 names 1

• Tina Wilkerson Former name

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Highlands Dermatology and Surgical AssociatesGroup PAC ID 0042458150, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cookeville Regional Medical Center Hospital, Cookeville, TN, CCN 440059

Merit-based Incentive Payment System (MIPS)

Final score

81.1 of 100Reported as group

Quality

88.86

Improvement activities

40

Cost

51.84

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tkelly@paducahderm.emadirect.md

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.

• Highlands Dermatology and Surgical Associates

  • Specialist
  • Cookeville, TN
  • NPI 1093151045
  Medicare reassignment Care Compare group NPD
• Paducah Dermatology PLLC

  • Dermatology Physician
  • Paducah, KY
  • NPI 1831242551

  TN

  Medicare reassignment NPD
• Martin Anesthesia Group Inc

  • Certified Registered Nurse Anesthetist
  • Martin, TN
  • NPI 1326107327
  NPD
• Premier Wound Care, PLLC

  dba Premier Wound Care

  • Family Nurse Practitioner
  • Union City, TN
  • NPI 1669355509
  NPD
• Richard S. Hall, M.D.

  • Specialist
  • Cookeville, TN
  • NPI 1235252818
  NPD (past)

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

• Cookeville Regional Medical Center

  • General Acute Care Hospital
  • Cookeville, TN
  • NPI 1275531956
  Care Compare affiliation

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1871277285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MCCOY MEDICAL",
            "address_2": "1324 SOUTH HOME STREET",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "38261",
            "telephone_number": "731-885-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MCCOY MEDICAL",
            "address_2": "1324 SOUTH HOME STREET",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "38261",
            "telephone_number": "731-885-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TINA",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "34204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "WILKERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffery W. Kaze, DMD
• Matthew Keathley, DNP, FNP-C
• Danielle Keller, PA-C
• Jason Todd Keller, D.C.
• Kisha Darlene Kelly, LCSW
• Kentenn Anesthesia
• Amanda Lee Keown, NP-C
• Khumalo Foot and Ankle Clinic, Inc
• Bhekumuzi McGlen Khumalo, DPM
• Kizer Clinic PLLC (Oasis Pain and Treatment Center)

• Family Nurse Practitioner in Union City, TN
• Providers in Union City, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.