Abode Care Partners LTC VB, LLC

Organization Active NPI Nurse Practitioner · Mountain City, TN

NPI 1972372225 · NPPES record last updated Jun 1, 2026

Key facts

NPI
1972372225
Entity type
Organization (NPI type 2)
Primary specialty
Nurse Practitioner 363L00000X
Legal business name
ABODE CARE PARTNERS LTC VB, LLC
Practice address
919 Medical Park Dr
Mountain City, TN 37683-1042
Phone
(800) 807-6555
Fax
(855) 316-2999
NPI assigned
Dec 28, 2023
Organization subpart
No

Authorized official

Name
Angie Mattingly
Title
MGR Provider Enrollment
Phone
(502) 420-2512

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 105

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 105

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240129001302 TN Part B Supplier - Clinic/Group Practice 8325316516 Receives reassigned benefits from 46 practitioners
Practice locations: Mountain City, TN

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X Yes

Addresses

Primary practice location

919 Medical Park Dr
Mountain City, TN 37683-1042

Mailing address

805 N Whittington Pkwy
Louisville, KY 40222-7101

Other providers in Mountain City, TN

All providers in Mountain City, TN · Nurse Practitioner in Tennessee

Sources for this page

Verify at the official NPI Registry.