Individual provider Active NPI

Michaela Lamae Edds, FNP-C

  • Family Nurse Practitioner
  • Tazewell, TN
National Provider Identifier
1881446326
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
36100 Issued in TN
Practice address
951 N Broad St
Tazewell, TN 37879-4323
Phone
(423) 259-8661
Fax
(423) 259-8662
NPI assigned
Apr 5, 2024
Last updated
Apr 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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 36100 TN Primary

Addresses

Primary practice location

951 N Broad St
Tazewell, TN 37879-4323

Mailing address

616 King Rd
Tazewell, TN 37879-5219
Phone (865) 279-2444

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
I20250129000113 TN Practitioner - Nurse Practitioner 3577005123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ado IncGroup PAC ID 9335485309, 7 clinicians

Practice addresses (Care Compare)

951 N Broad St
Tazewell, TN 37879-4323
Phone (423) 259-8661

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36100TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ado Inc. Family CurrentSince Oct 11, 2024 Accepting new patients

Locations

2975 Maynardville Hwy
Maynardville, TN 37807
Phone (865) 658-5353

951 N Broad St
Tazewell, TN 37879
Phone (423) 259-8661

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1712275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1881446326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 KING RD",
            "city": "TAZEWELL",
            "state": "TN",
            "postal_code": "378795219",
            "telephone_number": "865-279-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 N BROAD ST",
            "city": "TAZEWELL",
            "state": "TN",
            "postal_code": "378794323",
            "telephone_number": "423-259-8661",
            "fax_number": "423-259-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDDS",
        "first_name": "MICHAELA",
        "middle_name": "LAMAE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-05",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "36100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tazewell, TN

Sources for this page

Verify at the official NPI Registry.