Individual provider Active NPI

Eden Cheyenne Harmon, FNP-C

  • Family Nurse Practitioner
  • Rogersville, TN
National Provider Identifier
1992517445
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
38039 Issued in TN
Practice address
300 Park Blvd
Rogersville, TN 37857-2912
Phone
(423) 347-6021
NPI assigned
Jan 22, 2025
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 38039 TN Primary

Addresses

Primary practice location

300 Park Blvd
Rogersville, TN 37857-2912

Mailing address

1359 Old Highway 66
Rogersville, TN 37857-5133
Phone (423) 552-5073

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
I20250310001992 TN Practitioner - Nurse Practitioner 6901327790 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

1116 Hwy 11 W
Church Hill, TN 37642-3023
Phone (423) 226-5109

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38039TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Jan 22, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jan 22, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients

Locations

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

1116 Highway 11 W
Church Hill, TN 37642
Phone (423) 226-5109

52 Mouse Creek Rd NW
Cleveland, TN 37312
Phone (423) 559-9700

300 Park Blvd
Rogersville, TN 37857
Phone (423) 347-6021

Organizations & group practices 4

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": "1737504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1992517445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1359 OLD HIGHWAY 66",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378575133",
            "telephone_number": "423-552-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PARK BLVD",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378572912",
            "telephone_number": "423-347-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARMON",
        "first_name": "EDEN",
        "middle_name": "CHEYENNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-22",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "38039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogersville, TN

Sources for this page

Verify at the official NPI Registry.