Kellie Tankersley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2021 Hamilton Place Blvd
Chattanooga, TN 37421-6046

Phone

(423) 899-6222

NPI assigned

Oct 4, 2022

Last updated

Apr 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crossroads Urgent Care PLLCGroup PAC ID 8325117484, 181 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crossroads Urgent Care PLLC

  dba Urgent Team

  • Family Medicine Physician
  • Murfreesboro, TN
  • NPI 1366644361

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Crossroads Urgent Care PLLC

  dba Urgent Team

  • Rural Health Clinic/Center
  • South Pittsburg, TN
  • NPI 1427781129

  Physician Assistant

  NPD

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1902521891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 ISBILL RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374191609",
            "telephone_number": "423-718-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 HAMILTON PLACE BLVD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374216046",
            "telephone_number": "423-899-6222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Isbill Rd",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374191609",
            "country_code": "US",
            "telephone_number": "423-718-3851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANKERSLEY",
        "first_name": "KELLIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-04",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Talley, FNP-C
• Emily Talley
• Leah Talley, LPC-MHSP
• Shirley Talley, RN
• Gregory Ugale Tambio
• Bryan Tanner, CRNA
• Christine Barrett Tanner, MA, NCC
• Tyler Tantisook, MD
• John E Tapp II, MD
• Tara L Hewlett-Bryant (Fit 2 a T)

• Physician Assistant in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.