Individual provider Active NPI

Carrie Chastain Speck, GNP-BC

  • Gerontology Nurse Practitioner
  • Murfreesboro, TN
National Provider Identifier
1982880241
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APN0000013214 Issued in TN
Practice address
2140 N Thompson LN
Ste 100
Murfreesboro, TN 37129-6069
Phone
(615) 410-4990
Fax
(615) 410-4250
NPI assigned
Jan 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APN0000013214 TN Primary

Addresses

Primary practice location

2140 N Thompson LN
Ste 100
Murfreesboro, TN 37129-6069

Mailing address

1307 Bond CT
Murfreesboro, TN 37129-1475
Phone (615) 579-8820

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
I20090713000685 TN Practitioner - Nurse Practitioner 7810049459 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN0000013214TNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Corporate Wellness, LLC Gerontology CurrentSince Mar 7, 2020 Accepting new patients

Locations

1524 Williams Dr
Ste 102
Murfreesboro, TN 37129
Phone (615) 225-9100

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.

NPI Registry JSON

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1982880241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 BOND CT",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291475",
            "telephone_number": "615-579-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 N THOMPSON LN",
            "address_2": "STE 100",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371296069",
            "telephone_number": "615-410-4990",
            "fax_number": "615-410-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPECK",
        "first_name": "CARRIE",
        "middle_name": "CHASTAIN",
        "credential": "GNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-17",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TN",
            "license": "APN0000013214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.