Smokey Mountain Medical LLC
NPI 1902627169ActiveOrganization· Nurse Practitioner, Family· Jacksboro, TN
Nurse Practitioner, Family in Jacksboro, Tennessee, registered in NPPES in October 2024. The authorized official on file is Anthony Kingsley, APRN, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1902627169 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 21, 2024 |
| Last updated in NPPES | Nov 5, 2024 |
| Certified by provider | Nov 5, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TN) |
|---|
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