Individual provider Active NPI

Christie Hummel, FNP-BC

  • Family Nurse Practitioner
  • Cookeville, TN
National Provider Identifier
1962740217
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN6295 Issued in TN
Practice address
112 N. Walnut Ave
Cookeville, TN 38501
Phone
(931) 520-1414
Fax
(931) 520-1246
NPI assigned
Jan 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 6295 TN
Family Nurse Practitioner 363LF0000X APN6295 TN Primary

Addresses

Primary practice location

112 N. Walnut Ave
Cookeville, TN 38501

Mailing address

PO Box 1210
Cookeville, TN 38503-1210
Phone (931) 520-1414

Other names 1

  • Christie Kelley Former name

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
I20181109000406 TN Practitioner - Nurse Practitioner 5799039764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highlands Dermatology and Surgical AssociatesGroup PAC ID 0042458150, 4 clinicians

Practice addresses (Care Compare)

112 N Walnut Ave
Cookeville, TN 38501-2554
Phone (931) 520-1414

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APN6295TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Highlands Dermatology and Surgical Associates CurrentSince Sep 19, 2018 Accepting new patients
Richard S. Hall, M.D. PastSince Sep 19, 2018 Accepting new patients

Locations

112 N Walnut Ave
Cookeville, TN 38501
Phone (615) 520-1414

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1358812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1962740217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1210",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385031210",
            "telephone_number": "931-520-1414",
            "fax_number": "931-520-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N. WALNUT AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "38501",
            "telephone_number": "931-520-1414",
            "fax_number": "931-520-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMMEL",
        "first_name": "CHRISTIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-22",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "6295",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN6295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTIE",
            "last_name": "KELLEY",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.