Individual provider Active NPI

Paula Renner

  • Nurse Practitioner
  • Greeneville, TN
National Provider Identifier
1992136469
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN18012 Issued in TN
Practice address
438 E Vann Rd Ste 201
Greeneville, TN 37743-7202
Phone
(423) 278-1800
NPI assigned
Dec 9, 2013
Last updated
Jul 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN18012 TN Primary
Family Nurse Practitioner 363LF0000X APN18012 TN

Addresses

Primary practice location

438 E Vann Rd Ste 201
Greeneville, TN 37743-7202

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

906 Tusculum Blvd
Greeneville, TN 37745-4004
Phone (423) 787-0400

Other identifiers 1

IdentifierTypeStateIssuer
Q006367MedicaidTN

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
I20140321001357 TN Practitioner - Nurse Practitioner 5092946798 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Takoma Regional Hospital IncGroup PAC ID 8729189295, 28 clinicians

Practice addresses (Care Compare)

438 E Vann Rd
Suite 201
Greeneville, TN 37743-7202
Phone (423) 278-1800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN18012TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Takoma Regional Hospital, Inc CurrentSince Nov 1, 2017 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Takoma Regional Hospital Inc CurrentSince Nov 1, 2017 Accepting new patients
Wellmont Health System Current Accepting new patients
Wellmont Medical Associates Inc Nurse Practitioner CurrentSince Aug 1, 2024 Accepting new patients

Locations

1744 E Andrew Johnson Hwy
Greeneville, TN 37745
Phone (423) 636-8891

438 E Vann Rd
Ste 100
Greeneville, TN 37743
Phone (423) 278-1700

438 E Vann Rd
Ste 201
Greeneville, TN 37743
Phone (423) 278-1800

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

Interoperability endpoints

  • Direct secure messaging: prenner115144@balladhealth.medalliesdirect.net

Organizations & group practices 5

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": "1386547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1992136469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 E VANN RD STE 201",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377437202",
            "telephone_number": "423-278-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "906 Tusculum Blvd",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377454004",
            "country_code": "US",
            "telephone_number": "423-787-0400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENNER",
        "first_name": "PAULA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-09",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN18012",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN18012",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q006367",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeneville, TN

Sources for this page

Verify at the official NPI Registry.