Individual provider Active NPI

Katherine Mae Astaneh, FNP

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1902330269
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21612 Issued in TN
Practice address
403 N State of Franklin Rd
Johnson City, TN 37604-6034
Phone
(423) 431-7047
NPI assigned
Apr 13, 2017
Last updated
May 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 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 21612 TN Primary

Addresses

Primary practice location

403 N State of Franklin Rd
Johnson City, TN 37604-6034

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kastaneh197263@balladhealth.medalliesdirect.net Direct Blue Ridge Medical Management Corporation

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
I20180922000121 TN Practitioner - Nurse Practitioner 3072864586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
East Tennessee State University Quillen College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1497 W Elk Ave
Elizabethton, TN 37643-2896

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-4847

408 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-4946

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Apr 16, 2018 Accepting new patients
Wellmont Health System Current Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Apr 16, 2018 Accepting new patients

Locations

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

403 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-7042

Interoperability endpoints

  • Direct secure messaging: kastaneh197263@balladhealth.medalliesdirect.net

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.

Hospital & facility affiliations 3

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": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1902330269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046034",
            "telephone_number": "423-431-7047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASTANEH",
        "first_name": "KATHERINE",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-13",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kastaneh197263@balladhealth.medalliesdirect.net",
            "affiliation": "Y",
            "endpointDescription": "Ballad Health Care Everywhere",
            "affiliationName": "Blue Ridge Medical Management Corporation",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "403 N State Of Franklin Rd",
            "city": "Johnson City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376046034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.