Individual provider Active NPI

Aimee Elliott, NP

  • Adult Health Nurse Practitioner
  • Erwin, TN
National Provider Identifier
1992004824
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5012449 Issued in NC
Practice address
630 Oneega LN
Suite a
Erwin, TN 37650-2197
Phone
(423) 735-5700
Fax
(423) 735-5723
NPI assigned
Mar 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X 15675 TN
Adult Health Nurse Practitioner 363LA2200X 5012449 NC Primary

Addresses

Primary practice location

630 Oneega LN
Suite a
Erwin, TN 37650-2197

Mailing address

300 E Main St
Johnson City, TN 37601-5705
Phone (423) 979-0000

Other identifiers 4

IdentifierTypeStateIssuer
7005680MedicaidNC
P00954810OtherTNRR MEDICARE
1524893MedicaidTN
1992004824MedicaidVA

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
I20110726000385 TN Practitioner - Nurse Practitioner 4486822038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NP Health of TN PLLCGroup PAC ID 5395159883, 41 clinicians

Practice addresses (Care Compare)

2012 Sherwood Dr
Johnson City, TN 37601-3238
Phone (432) 232-8200

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15675TNMDAnesthesiology Physician
5012449NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NP Health of TN PLLC CurrentSince Jan 1, 2021 Accepting new patients
Matrix Medical Plus CurrentSince Oct 1, 2024 Accepting new patients
Renuven Health Partners of Georgia PC Past Accepting new patients

Locations

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

5100 Poplar Ave
Fl 27
Memphis, TN 38137
Phone (205) 538-3076

6500 Kirby Gate Blvd
Memphis, TN 38119
Phone (901) 230-2232

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

Organizations & group practices 3

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": "1300320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1992004824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MAIN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376015705",
            "telephone_number": "423-979-0000",
            "fax_number": "423-979-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 ONEEGA LN",
            "address_2": "SUITE A",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376502197",
            "telephone_number": "423-735-5700",
            "fax_number": "423-735-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "AIMEE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-17",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "TN",
            "license": "15675",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5012449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005680",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00954810",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1524893",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992004824",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erwin, TN

Sources for this page

Verify at the official NPI Registry.