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MRS. BEVERLY JANE WADDELL ANP GCNS NPI 1811161813


NPI Information

NPI: 1811161813
Provider Name: MRS. BEVERLY JANE WADDELL, ANP, GCNS
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
105 W STONE DR
STE 5C
KINGSPORT, TN
ZIP 37660
Phone: (423) 378-7645
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MRS. Beverly Jane Waddell, ANP, GCNS is an adult health nurse practitioner in Kingsport, TN with 17 years of experience. MRS. Beverly Jane Waddell, ANP, GCNS NPI is 1811161813. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

105 W STONE DR
STE 5C
KINGSPORT, TN
ZIP 37660-365
Phone: (423) 378-7645
Fax: (423) 392-3863

The NPI 1811161813 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

The enumeration date for this NPI number is 4/22/2008 and was last updated on 11/18/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1163W00000XRegistered NurseRN129155TENNESSEENo
2363LA2200XNurse PractitionerAdult HealthAPN13413TENNESSEEYes
3364SG0600XClinical Nurse SpecialistGerontology13413TENNESSEENo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11510164MEDICAIDTENNESSEE
23341872MEDICARE UPINTENNESSEE
3103I086169MEDICARE UPINTENNESSEE
43700592MEDICARE UPINTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.