Kayla O Almanzor, NP
Individual provider Active NPI Family Nurse Practitioner · Johnson City, TN
NPI 1912434820 · NPPES record last updated Oct 4, 2023
Key facts
- NPI
- 1912434820
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 23190 (TN)
- Practice address
- 301 Med Tech Pkwy Ste 240
Johnson City, TN 37604-2641 - Phone
- (423) 794-5520
- Fax
- (423) 282-6940
- NPI assigned
- May 23, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wellmont Medical Associates Inc
Practice addresses (Care Compare)
111 W Stone Dr
Kingsport, TN 37660-6027
130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 230-8200
2000 Brookside Dr
Kingsport, TN 37660-4627
Phone (423) 578-8500
2204 Pavilion Dr
Suite 110
Kingsport, TN 37660-4651
Phone (423) 224-2369
Hospital & facility affiliations
- Indian Path Community Hospital
- Wellmont Holston Valley Medical Center
- Lonesome Pine Hospital
- Franklin Woods Community Hospital
- Wellmont Bristol Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171024001806 | TN | Practitioner - Nurse Practitioner | 9234405978 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 194223 | TN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellmont Medical Associates, Inc. | Current |
Accepting new patients | |
| State of Franklin Healthcare Associates PLLC | Current |
Accepting new patients | |
| State of Franklin Healthcare Associates PLLC | Current |
Accepting new patients | |
| Wellmont Medical Associates, Inc. | Past |
Accepting new patients | |
| Blue Ridge Medical Management Corporation | Family | Past | Accepting new patients |
Locations
313 Princeton Rd
Ste 3
Johnson City, TN 37601
Phone (423) 282-4819
301 Med Tech Pkwy
Ste 240
Johnson City, TN 37604
Phone (423) 794-5520
301 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 302-6239
105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220
Interoperability endpoints
- https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 194223 | TN | |
| Family Nurse Practitioner | 363LF0000X | 23190 | TN | Yes |
Addresses
Primary practice location
301 Med Tech Pkwy Ste 240
Johnson City, TN 37604-2641
Mailing address
PO Box 3889
Johnson City, TN 37602-3889
Phone (423) 433-6625
Other names
- Kayla P Owens
NPI Registry JSON
{
"created_epoch": "1495497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696377600000",
"number": "1912434820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3889",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376023889",
"telephone_number": "423-433-6625",
"fax_number": "423-723-2669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 MED TECH PKWY STE 240",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042641",
"telephone_number": "423-794-5520",
"fax_number": "423-282-6940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALMANZOR",
"first_name": "KAYLA",
"middle_name": "O",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-23",
"last_updated": "2023-10-04",
"certification_date": "2023-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "194223",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "23190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KAYLA",
"last_name": "OWENS",
"middle_name": "P",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Johnson City, TN
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- Patricia Nester Allingham
- Russell Reid Allison
- Michael J Allshouse
- Melony April Almany
- Tammy Kim Almond
- Sergio Gabriel Alonso
- Hamza Manaf Mahmoud Altal
- Jason L Altman
- J. Michael Amburgey
All providers in Johnson City, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.