Individual provider Active NPI

Brandie Valynn Haga, FNP-DNP

  • Family Nurse Practitioner
  • Antioch, TN
National Provider Identifier
1912730284
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
36926 Issued in TN
Practice address
3405 Old Anderson Rd Unit 112
Antioch, TN 37013-1025
Phone
(423) 943-4802
NPI assigned
Aug 22, 2024
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 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 36926 TN Primary

Addresses

Primary practice location

3405 Old Anderson Rd Unit 112
Antioch, TN 37013-1025

Mailing address

3405 Old Anderson Rd Unit 112
Antioch, TN 37013-1025
Phone (423) 943-4802

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
I20241227001189 TN Practitioner - Nurse Practitioner 6103353495 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Oncology PLLC CurrentSince Dec 9, 2024 Accepting new patients

Locations

2004 Hayes St
Ste 350
Nashville, TN 37203
Phone (615) 312-3333

2004 Hayes St
Ste 800
Nashville, TN 37203
Phone (615) 514-3023

322 22nd Ave N
Ste 200
Nashville, TN 37203
Phone (615) 986-7600

1750 Cedar Ln
Ste 200
Tullahoma, TN 37388
Phone (615) 333-2481

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.

NPI Registry JSON

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1912730284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 OLD ANDERSON RD UNIT 112",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370131025",
            "telephone_number": "423-943-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 OLD ANDERSON RD UNIT 112",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370131025",
            "telephone_number": "423-943-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGA",
        "first_name": "BRANDIE",
        "middle_name": "VALYNN",
        "credential": "FNP-DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "36926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, TN

Sources for this page

Verify at the official NPI Registry.